Nasotracheal intubation without Nasal trauma , bleeding or ETT contamination

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Journal Title, Volume, Page: 
journals.sfu.ca, Vol 6, No 4 (2014)
Year of Publication: 
2014
Authors: 
Dr: Wael Sadaqa
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestin
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestin
Preferred Abstract (Original): 

Our Hypothesis was that the nasopharyngeal passage of the endotracheal tube can be facilitated by (a sterile gloves finger ) acting as a pathfinder . Accordingly , we performed a randomized , controlled trial with blinded assessment of nasopharyngeal bleeding and contamination of the tip of the endotracheal tube . After the induction of anesthesia , the tip of the ETT was inserted into the gloves finger before it was inserted into the more patent nostril. In the control group (n=40), the gloves finger was retrieved before nasopharyngeal passage was attempted with an endotracheal tube ( inner diameter , 7.0 mm ). While in the intervention group (n=40) , the gloves finger was kept in position .Then we inserted the tip of the endotracheal tube into the gloves finger .subsequently , the endotracheal tube was advanced under visual control to the oropharynx . After the endotracheal tube was positioned in the oropharynx , the gloves finger was removed and intubation completed. Six hours after surgery , we determined the patients, nasal pain .The pathfinder technique reduced the incidence (p <0.001) , and severity ( p = 0.001) of bleeding , decreased tube contamination with blood and mucus (p < 0.001) , and diminished postoperative nasal pain (p = 0.035) . IMPLICATIONS: Nasopharyngeal passage of an endotracheal tube can be facilitated by a sterile gloves finger (nasopharyngeal airway) covering and guiding the rigid tube tip. This technique is helpful in reducing the incidence and severity of nosebleeds and in minimizing contamination of the tip of the endotracheal tube with blood and mucus.