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Chapter 13 - Tracheal intubation: flexible fibreoptic

from Section 2 - Clinical

Published online by Cambridge University Press:  10 January 2011

Ian Calder
Affiliation:
National Hospital for Neurology and Royal London Hospital
Adrian Pearce
Affiliation:
Guy's and St Thomas' Hospital, London
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Summary

Understanding the equipment, knowledge of airway anatomy, good endoscopy skills, correct choice of tubes and railroading techniques are vital to the success of flexible fibreoptic intubation techniques. The modern day flexible fibreoptic scope consists of the following parts: body, insertion cord, light source, and camera and monitor. There are three ways in which an endoscopist can manipulate the tip of the fibrescope towards the desired target. These are advancement, tip deflection and rotation. Fibreoptic endoscopy involves guiding the tip of the fibrescope from the nose or the mouth into the trachea under continuous vision. The final stage of fibreoptic intubation involves railroading the tracheal tube and removing the fibrescope from the tube. Flexible fibreoptic intubation has revolutionised the management of patients with known anatomical airway difficulties. The practical fibreoptic techniques include awake fibreoptic intubation, asleep fibreoptic intubation, and retrograde fibreoptic intubation.
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Publisher: Cambridge University Press
Print publication year: 2010

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