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November 15, 1976

Tactile Orotracheal Intubation

Author Affiliations

Mercy Hospital Baltimore

JAMA. 1976;236(20):2288. doi:10.1001/jama.1976.03270210020014

To the Editor.—  An obese, shortnecked, patient with chronic obstructive pulmonary disease and an old closed tracheostomy suffered a cardiopulmonary arrest postoperatively. Extreme bronchoconstriction made mouth to mouth and bag ventilation difficult. Several attempts to pass an endotracheal tube by the conventional method were unsuccessful. Because the need to intubate the patient was critical, the operator discarded the laryngoscope and, by placing two fingers into the oropharynx and against the epiglottis, easily guided the endotracheal tube into the trachea.Although this may not be the method of choice, it was easily performed in an emergency situation by a person without prior training or experience. Familiarity with the anatomy of the area and knowledge of the complications of intubation are prerequisites. It would seem prudent to reserve the technique for comatose patients. Although the technique is described in the anesthesia literature, it is not widely known.1,2 The intent of this