Rapid Responses

The primary purpose of Rapid Responses is to provide a venue for readers to comment on and discuss scientific content published in CJA Online.

Please note that Rapid Response comments must be made in one of Canada's official languages, English or French, to solicit response.

General comments or concerns should be sent to the communications{at}cas.ca.

Electronic Letters to:

Case Reports/Case Series: Maria Uria, Karen Kost, Thomas Schricker, and Steven B. Backman Case report: Nasotracheal intubation - look before leaping to assess the laryngeal view: [Présentation de cas : Intubation nasotrachéale : observer avant de se précipiter pour évaluer la vue laryngée] Can J Anesth 2008; 55: 302-305 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

Nasotracheal intubation - look before you leap

Peter W Duncan   (2 May 2008)

Nasotracheal intubation - look before you leap 2 May 2008
Peter W Duncan, Consultant Anaesthetist Royal Preston Hospital, Preston, Lancashire, United Kingdom Send letter to journal: Re: Nasotracheal intubation - look before you leap peter.duncan{at}lthtr.nhs.uk Peter W Duncan	I was impressed by the elegant way in which Uria and colleagues managed to change an oral endotracheal tube to a nasal one with the use of a bougie. However I do not agree with their assertion that one should always undertake a direct laryngoscopy before attempting to pass a nasal endotracheal tube. I always attempt to insert nasal endotracheal tubes "blind" and encourage all trainees accompanying me to also try a "blind" technique. It is then informative to assess the grade of laryngoscopy and enjoy the feeling of relief to find the patient safely intubated when it is difficult or impossible to see the larynx. Am I teaching and practising a technique threatened with extinction which we should try to preserve or should I follow Uria's advice and always look before I leap and abandon "blind" nasal intubation to the dustbin of history?