Intubation contraindications can be divided into those Both Nasal and Oral lntubation and those for Nasal Intubation.
Both Nasal and Oral lntubation Contraindications
• Laryngeal edema.
This is one among the important Intubation Contraindications. In these conditions the airway is already compromised giving very little place for the endotracheal Tube to pass. Attempt to intubate can aggravate these conditions and can produce severe respiratory Obstruction so in these conditions whenever there is severe respiratory distress, tracheostomy is preferred.
If intubation has to be performed it should be very gentle with expert hands and should be tried only in mild cases.
Nasal Intubation Contraindications
The Intubation Contraindications for nasal intubatins are a little different from that of the oral intubation.
1. Basal skull fractures and CSF rhinorrhea: There have been case reports of tube reaching cranium and also CSF leak into nose can cause cerebral infection. Hence before ant intubation, history of any head injury and the type of injury should be assessed. Oral intubation is safer in such cases.
2. Bleeding disorders. The Nasal and Septal mucosa are highly vascular areas especially the little’s are and the Kiselbach’s plexus, which can bleed profusely with minimal trauma.
3. Nasal polyp, Abscess, or foreign body: These will cause obstruction to the tube and can also make surgery difficult.
4. Previous nasal surgery is only relative contraindication.