Blind digital intubation is a technique that is rarely used, and few clinicians have had the chance of performing it, or being trained on its use. A guide to blind digital intubation is available online "in press" in Trends in Anaesthesia and Critical Care, by H. Miguel Alcalde, J. Bollici Martínez, A.M. Martín Rubio from the Department of Anaesthesiology and Resuscitation, Santa Bárbara Hospital, Spain. The authors note that digital blind intubation is indicated when alternative equipment is not working or not available, when there is difficult positioning of the patient, poor lighting, blood or vomiting into the airway stopping laryngoscopic vision, potential or actual cervical spine instability or situations of accidental extubation.
The paper outlines the technique, required personnel and equipment as well as potential difficulties. In their own hospital, the authors conducted a comparison of blind digital intubation versus ultrasound-guided intubation, with 30 patients analysed using each technique. The results were similar, and the authors concluded that in patients without any difficulties for intubation, the blind digital technique achieves successful tracheal intubation in a high proportion of cases. The use of ultrasound slightly improves such results, improves safety and reliability and builds self confidence and skills of the doctor performing digital intubation.
An accompanying discussion by Edwin Seet and Chandra M Kumar, notes the successful use of ultrasound, and suggests: “In the current era where rear-view cameras are commonplace in the automobile industry to ensure safety, the imperative is for the anaesthesia community to embrace technology and change for the better. Intubation perhaps should not be blind anymore.”
Source: Trends in Anaesthesia and Critical Care
Image credit: Wikimedia Commons By Vavoor - Own work, CC BY-SA 3.0
The paper outlines the technique, required personnel and equipment as well as potential difficulties. In their own hospital, the authors conducted a comparison of blind digital intubation versus ultrasound-guided intubation, with 30 patients analysed using each technique. The results were similar, and the authors concluded that in patients without any difficulties for intubation, the blind digital technique achieves successful tracheal intubation in a high proportion of cases. The use of ultrasound slightly improves such results, improves safety and reliability and builds self confidence and skills of the doctor performing digital intubation.
An accompanying discussion by Edwin Seet and Chandra M Kumar, notes the successful use of ultrasound, and suggests: “In the current era where rear-view cameras are commonplace in the automobile industry to ensure safety, the imperative is for the anaesthesia community to embrace technology and change for the better. Intubation perhaps should not be blind anymore.”
Source: Trends in Anaesthesia and Critical Care
Image credit: Wikimedia Commons By Vavoor - Own work, CC BY-SA 3.0
References:
Miguel Alcade H, Bollici Martínez J, Martín Rubio AM. Digital intubation: never blind anymore. Trends
in Anaesthesia and Critical Care. In press. DOI: http://dx.doi.org/10.1016/j.tacc.2016.02.002
Seet E, Kumar CM Digital intubation: never blind anymore. Trends in Anaesthesia and Critical Care. In press. DOI: http://dx.doi.org/10.1016/j.tacc.2016.03.002
Seet E, Kumar CM Digital intubation: never blind anymore. Trends in Anaesthesia and Critical Care. In press. DOI: http://dx.doi.org/10.1016/j.tacc.2016.03.002
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