An Approach for Safe Conversion of an Oral Endotracheal Tube to a Nasal Endotracheal Tube

Abstract

We present an approach for safe management of a patient with an oral endotracheal tube who required conversion to a nasal endotracheal tube. A 35-year-old man presented for mandibular fracture repair after multiple injuries sustained in a motor vehicle accident. The patient already had an oral endotracheal tube, and the surgical team requested a nasal endotracheal tube to facilitate surgical exposure and postoperative airway management in anticipation of a wired jaw. A nasal endotracheal tube was inserted through the naris and a video laryngoscope was used to visualize the glottis. A tracheal tube introducer was inserted through the oral endotracheal tube, and the oral endotracheal tube was then withdrawn approximately 5 cm. The nasal endotracheal tube was advanced through the vocal cords alongside the tracheal tube introducer. The nasal endotracheal tube cuff was then inflated and the tracheal tube introducer was withdrawn.