image by: The Protected Airway Collaborative

HWN Suggests

Fiberoptic Awake Oral Intubation

Fiberoptic oral intubation with flexible fiberoptic endoscope is a useful technique for establishing an airway in patients with abnormal upper airway anatomy, cervical immobilization, or awake intubations with preservation of the patient’s respiratory drive to when it is desirable to maintain spontaneously breathing during the intubation. Unlike endoscope or blind nasotracheal intubations, an oral approach can be more challenging because the scope must make a sharp turn in the posterior oropharynx before entering the hypopharynx. During nasotracheal intubation, the scope can make the turn in the nasopharynx and take a straight path towards the trachea.

read full article

Featured

 Fiberoptic Intubation Technique

In this rapid review we take you through the procedure of fiberoptic intubation using a Williams Oral Airway.

Articles of Interest

Awake Bronchoscopic Intubation

This module covers the process of bronchoscopic intubation, commencing once the patient is adequately topicalized and sedated and finishing when ETT placement is confirmed in the trachea.

Awake Fiberoptic Intubation. Why is it Done?

Awake fiberoptic intubation is an effective and safe technique that can be utilized when a patient has a challenging airway anatomy that needs to be secured. It is also an effective solution for anticipated difficulties that may arise during conventional intubation.

Difficulty airway management- adult awake fiberoptic intubation - considerations

Ask for these items immediately: Bronchoscope, Respiratory therapy with a vent, ER physician with drugs for sedation, 4% lidocaine from pharmacy; and then focus on getting your bronchoscope set up, while other personnel get organized'

Fiberoptic Intubation: An Overview and Update

Fiberoptic bronchoscopes are currently used to facilitate endotracheal intubation via either the nasal or oral route, in the positioning of endotracheal and endobronchial tubes and bronchial blocking devices, and in airway examination or evaluation. In clinical scenarios in which tracheal intubation is deemed necessary and mask or supraglottic ventilation (eg, via a laryngeal mask airway [LMA]) is unlikely to be successful or poses an aspiration risk, awake FOI is a standard approach.

Fibreoptic intubation in airway management: a review article

The intubating fibreoptic bronchoscope (FOB) was first described in 1967 by Peter Murphy and has a quoted success rate of 88%–100%. Some authors still consider it to be the gold standard in anticipated difficult airway management. The introduction of newer equipment, such as supraglottic airway devices, and indirect laryngoscopy has dramatically changed airway management and resulted in a decline in the use of fibreoptic intubation (FOI).

The Expedient Awake Fiberoptic Intubation

A five-minute video demonstrating how to easily perform airway blocks for a smooth and efficient awake fiberoptic intubation.