View source for Blind digital intubation

==Overview==
*First introduced in 1880 when William MacEwan administered anesthesia through a metal tube inserted into the trachea by touch
*Fell out of favor in 1907 with introduction of [[laryngoscopy]]

==Indications==
*Can be considered in any patient requiring [[Intubation|endotracheal intubation]]
*Can be used as a rescue method when traditional [[Direct laryngoscopy|laryngoscopy]] fails
*Especially useful in:
**Austere environments where laryngoscopy is not accessible
**Out-of-hospital situations where patient is in confined space and cannot be extricated
**Copious secretions, blood or vomitus obscuring visualization of airway
**Cervical-spine precautions
**Grade III/IV Cormack-Lehane view with laryngoscopy

==Contraindications==
*Severe facial trauma prohibiting endotracheal intubation via the oropharyngeal route

==Equipment Needed==
*Disposable gloves
*Endotracheal tube
*Can consider [[bougie]]-assisted technique <ref>Rich JM. Successful blind digital intubation with a bougie introducer in a patient with an unexpected difficult airway. Proc (Bayl Univ Med Cent). 2008;21(4):397-399. doi:10.1080/08998280.2008.11928436</ref>

==Procedure==
[[File:digitalintubation.png|thumb|<ref>Hardwick WC, Bluhm D. Digital intubation. Journal of Emergency Medicine 1984; 1: 317– 20.</ref>]]
#Insert the index and middle fingers of the nondominant hand into the oral cavity
#Trace volar surface of fingers over dorsal surface of the tongue
#Palpate and lift epiglottis
#Insert ETT with dominant hand
#Lifting epiglottis with index finger, use middle finger to guide tube through vocal cords.

==Complications==
*Trauma to provider from patient's teeth

==See Also==
===Airway Pages===
*Pre-intubation
**[[Predicting the difficult airway]]
**[[Bag valve mask ventilation]]
**[[Apneic oxygenation]]
***[[EBQ:ED Preoxygenation]]
*Induction
**[[Critical care quick reference]]
**[[Rapid sequence intubation]]
**[[Delayed sequence intubation]]
*[[Intubation]]
**[[Intubation (peds)]]
**[[Direct laryngoscopy]]
**[[Video Laryngoscopy]]
**[[Bougie]]
**[[The difficult airway]]
**[[Advanced airway adjuncts]]
***[[Supraglottic airway]]
**Non-traditional intubation
***[[Awake intubation]]
***[[Nasal intubation]]
***[[Blind Digital Intubation]]
*[[Surgical airways]]
**[[Surgical cricothyrotomy]]
**[[Needle cricothyrotomy]]
**[[Pediatric jet ventilation]]
*Post-intubation
**[[Mechanical ventilation (main)]]
**[[Deterioration after intubation]] (DOPE)

==External Links==

===Videos===
{{#widget:YouTube|id=WbQEJ52Qa-w}}

==References==

<references/>

[[Category:Procedures]]
[[Category:Critical Care]]