Tactile orotracheal intubation

A previously described method for tactile (digital) endotracheal intubation was refined for use in deeply comatose patients. This technique, consisting of introduction of the endotracheal tube by palpation of the epiglottis, was practiced in cadaver subjects and then applied in both field and emergency department settings. Because the procedure can be carried out without movement of the head and neck and even with an immobilization device in place, it was found particularly suitable in trauma patients who might have suffered injury to the cervical spine. An added advantage is the ease of performance despite secretions or blood in the upper airway. This technique should prove useful to clinicians involved in the early care of critically ill or injured patients.