Blind Nasal Intubation

Blind nasal intubation is the technique of intubation wherein a nasotracheal tube is passed into the trachea through the nose, without visualization of the glottis with laryngoscope. This is an advanced method that can be carried out only in experienced and skilled hands especially like those of the anesthetists.

A blind nasal intubation should always be carried out when the patients are awake, in the sense that they should not be heavily sedated or given any muscle relaxants.

This is so because the cases in which this method is followed are cases of difficult intubation and may be in full stomach especially during emergencies. So, in such cases to avoid the risk of aspiration and airway compromise, Blind nasal intubation is always done while patient is awake. This is also called as Awake intubation.

Blind nasal intubation is different than the routine nasal intubation, where laryngoscopy is done after the tube is passed inside the nasal cavity, so that the tube is guided through the vocal cords into the trachea under direst vision, with support of Magill’s forceps if necessary.

Blind nasal intubation is indicated in conditions where laryngoscopy is not possible due to inadequate mouth opening like in:

i. Temporomandibular joint ankylosis.
ii. Trismus because of quinsy, tetanus etc.
iii. Neck contractures.