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EMCrit 406 - Awake NasoTracheal Intubation (AFOI)

EMCrit FOAM Feed

Scott D. Weingart, MD FCCM

Medicine, Health & Fitness, Science

4.82K Ratings

🗓️ 17 August 2025

⏱️ 27 minutes

🧾️ Download transcript

Summary

Transcript

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0:00.0

Hey folks, Scott Weingard here, and this is an Amicrit podcast. Today, on the podcast, we're going to

0:06.2

discuss awake nasotracheal intubation. And I don't know why, but this was an itch I had a scratch.

0:13.9

I wanted to do this episode. And in fact, it would make more sense if I did the oral

0:17.9

intubation with a bronchoscope first. But I don't know, this was the one I had a

0:25.1

hankering to get done. It took a lot of logistic searches. That's what this episode primarily

0:31.7

is going to be about, is the logistics of awake nasotracheal intubation. And then on that show on the oral, that's when I'll go over

0:39.8

scope movement and a lot of stuff on the actual performance of using a bronchoscope for intubation.

0:48.8

I'll touch on that a little bit today, but that'll be saved for the next time in its majority.

0:55.3

So today, really,

1:00.8

nasotrachial intubation is a lot of logistics. It's a lot of getting stuff right before you ever get to the patient who needs it. And if you don't have that done, it's going to be a real

1:04.5

pain in the butt. You're going to be really surprised at how annoying it is when you have

1:10.1

a size six tube and you finally found the cords,

1:13.5

dropped your scope, and are ready to pass the tube and realize it doesn't come close to reaching,

1:17.2

which, you know, you have to discover that for yourself once on a really critical patient

1:22.4

to realize you never want it to happen again. So that's what we're going to be dealing with a lot

1:26.3

today. Before we get there, a quick plea.

1:30.5

Folks, before we jump in, I want to tell you about an event that I'm trying to get off

1:35.0

the ground with some of my friends. It's awake and aware six. And I've participated in the last

1:42.3

three of these, some of the best conferences I've ever gone to in the non-clinical space.

1:48.0

We did it last year. It was the best ever. We all left that conference, all of the participants, all of the instructors, and said that was something magical.

1:56.0

We had basically created a bubble. Our everyday lives had disappeared. I had spoken to people at a level

2:02.5

of depth that I don't often get to do in regular life. It was just fantastic. The feedback was

...

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