Rapid sequence intubation
May be indicated when laryngoscopy is predicted to be difficult or neuromuscular blockade is contraindicated.
Nares should be sprayed with topical vasoconstrictor and anesthetic.
Tube size is generally 1.0 mm smaller than that used for an oral intubation.
The tube is inserted in a spontaneously breathing patient, ideally upon the initiation of inspiration.
The optimal depth placement of a nasotracheal tube, measured from the nares, is 28 cm in men and 26 cm in women.
Nasotracheal intubation is associated with lower success rate and a higher complication rate than RSI-assisted orotracheal intubation.