Nasotracheal intubation (NTI) involves
passing an endotracheal tube through the naris into the nasopharynx and the trachea
; most commonly after induction of general anesthesia in the operating room.
When do you do Nasotracheal intubation?
Nasotracheal intubation may be performed in
patients undergoing maxillofacial surgery or dental procedures
or when orotracheal intubation is not feasible (eg, in patients with limited mouth opening).
When is nasal intubation used?
It is best in patients who are
not critically hypoxic
and in whom there is obvious oral pathology making intubation and ventilation through the mouth problematic. When the mouth is off limits, nasal intubation can be a valuable technique for gaining an emergency airway.
What is the purpose of a Nasotracheal tube?
Nasotracheal intubation (NTI) is one of the commonest methods used
to induce anaesthesia for surgeries of the head and neck region
. NTI involves the tracheal tube to pass through nose hence allowing better isolation and good surgical access for intraoral procedures.
What are the advantages of Nasotracheal intubation?
Both nasal and oral route for intubation have advantages and disadvantages.
Oral intubation is easier to perform, faster and less painful than nasal intubation
under direct laryngoscopy, while blind nasal intubation represents a good alternative in conscious patient, without sedation.
What are the contraindications for Nasotracheal intubation?
51-1).
Fractures of the frontal part of the skull base with cerebrospinal rhinorrhea, intranasal abscesses or abscesses with intranasal expansion
, choanal atresia, hyperplastic tonsils, tendency to uncontrollable nasal bleeding, and coagulopathies are considered contraindications to nasotracheal intubation.
What are the side effects of intubation?
- damage to the vocal cords.
- bleeding.
- infection.
- tearing or puncturing of tissue in the chest cavity that can lead to lung collapse.
- injury to throat or trachea.
- damage to dental work or injury to teeth.
- fluid buildup.
- aspiration.
What are the complications of nasal intubation?
Complications of nasotracheal intubation include the following:
Epistaxis
(the most common complication), resulting from abrasion of the nasal mucosa when the tube is passed posteriorly. Damage to nasal cavity (avulsion of nasal polyps, fracture of the turbinates, septal abscesses) Aspiration.
Do they intubate you for nose surgery?
General Anesthesia for Rhinoplasty Surgery in California
The patient is intubated
, which means that a tube is placed in ones throat (trachea) which is connected to an anesthesia machine.
What can be used to facilitate Nasotracheal intubation?
- Listening to breath sounds directly through the ETT or using an extension tube and earpiece[27]
- Inflating the tracheal cuff (the cuff of the ETT is inflated in the oropharynx to help guide the tip of the tube into the trachea)[28,29]
Why is intubation done?
Intubation is done because
the patient cannot maintain their airway, cannot breathe on their own without assistance
, or both. They may be going under anesthesia and will be unable to breathe on their own during surgery, or they may be too sick or injured to provide enough oxygen to the body without assistance.
What are two types of laryngoscope blades?
Laryngoscopes are designed for visualization of the vocal cords and for placement of the ETT into the trachea under direct vision. The two main types are
the curved Macintosh blade and the straight blade
(i.e., Miller with a curved tip and Wisconsin or Foregger with a straight tip).
What is an intubation procedure?
Intubation is a procedure that’s used when you can’t breathe on your own.
Your doctor puts a tube down your throat and into your windpipe to make it easier to get air into and out of your lungs
. A machine called a ventilator pumps in air with extra oxygen.
Is intubation and tracheostomy the same thing?
A tracheostomy is another type of artificial airway
. The word intubation means to “insert a tube”. Usually, the word intubation is used in reference to the insertion of an endotracheal tube (Image 1). Patients may need an endotracheal tube for one of several reasons.
What does intubated and sedated mean?
Intubating a patient is a highly skilled procedure and involves inserting a tube through the patient’s mouth and into their airway: patients
are usually sedated
, allowing their mouth and airway to relax.
Are you awake when intubated?
The two arms of awake intubation are local anesthesia and systemic sedation. The more cooperative your patient, the more you can rely on local;
perfectly cooperative patients can be intubated awake without any
sedation at all. More commonly in the ED, patients will require sedation.
