2-12. PROCEDURAL STEPS FOR INTUBATING--NASOTRACHEAL TUBE
a. Intubate with a nasotracheal tube in the same way as you would with an
orotracheal tube. There are some differences, and these differences are listed here.
b. Use the most patent nare. That is, insert the tube in the nostril which is the
c. Advance the tube while you listen to breath sounds.
d. Use the Magill forceps to advance the tube into the larynx. Begin using the
forceps when the tube appears in the oropharynx.
e. Be sure the bevel of the tube is adjacent to the nasal septum when the tube is
f. Tape the tube across the casualty's nose and cheek on the side that is used.
2-13. EXTUBATING AN ET
The procedure is the same for the nasotracheal tube and the orotracheal tube.
Follow these steps:
a. Suction the bronchial tree as required:
Initiate cardiac monitoring.
Preoxygenate for at least 3 minutes.
Advance the catheter as far as possible with the suction off.
(4) Apply intermittent suction while slowly withdrawing the catheter in a
DO NOT apply suction for more than 5 seconds.
b. Reoxygenate the patient with two slow breaths.
c. Deflate the cuff using the syringe.
d. Remove the tube at the end of inspiration (inhaling).
e. Clear and maintain an open (patent) airway.