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Digital Intubation

Patrick Shipsey, MD
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No me gusta!

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Go on put your finger in there! It's gonna be alright.

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Minh L., Dr -

thanks Patrick! to answer your question about the role of digital intubation in prehospital, EMS and remote area airway management, yes it has a small role. It certainly has helped out in at least one difficult airway I know!

I first learnt of this technique from a South African ex special forces military doctor. It is indeed easy to learn and in select cases as you cite, easy to perform.

Once you get over the idea that sticking your fingers into someones mouth is acceptable and safe ( esp when they are already paralysed like after a failed RSI ETI!) then it is a good technique to have on hand ( literally!)

Nowadays you are right with all the airway toys, folks tend to disregard this option as it seems too simple!

Certainly worth a try if you are about to cut the neck!

Jonathan W., M.D. -

I stopped doing Digital Intubations in 1977 when I noticed small abrasions over top of my fingers and knuckes.

Jonathan Wasserberger MD

daniel m. -

Dr. Wasserberger makes a relevant point, but it does beg the question; Were you using full RSI (effective doses of paralytics and sedatives) in 1977?

PMP -

Thanks Dr. Shipsey! I first learned about this technique in the early 90's before medical school while working in EMS. Definitely useful when you cannot visualized due to thick emesis. One note, if you have large hands or a smaller adult patient, a gum bougie is a VERY nice adjunct to this technique! I usually get odd looks when describing this technique to residents, but it is something to keep in the mental toolbox when you are in a pinch.

Chris F. -

I tried this in cadaver lab and could not get it after multiple attempts. Then, I easily passed a bougie without even looking, no problem. I think I may stick with the bougie.

Henry A., -

I'm unable to access the you tube video...please help thanks!!

Alan P. -

Where is the video?

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Episode 140 Full episode audio for MD edition 238:22 min - 100 MB - M4AResumen Mayo 2013 en español Español 80:43 min - 28 MB - MP3EM:RAP 2013 May MP3 81 MB - ZIPEM:RAP May 2013 Written Summmary 857 KB - PDFEM:RAP May 2013 Board Review Questions 635 KB - PDFEM:RAP May 2013 Board Review Questions:Answer Sheet 661 KB - PDF