A SURVEY OF NASOTRACHEAL INTUBATING SKILLS AMONG ADVANCED TRAUMA LIFE-SUPPORT COURSE GRADUATES

The American College of Surgeons' Advanced Trauma Life Support procedu re teaches that blind nasotracheal intubation should be performed in t he presence of a suspected or proven cervical spine injury in an uncon scious but breathing patient who requires an artificial airway. We stu died a group of non-anaesthetically trained graduates of the Advanced Trauma Life Support course and examined their skill in performing blin d nasal intubations. Only six in 90 attempts were successful. We concl ude that, in British hospitals, blind nasotracheal intubation should n ot be recommended as the first line management in securing the airway of patients with suspected or proven cervical spine injury. Alternativ e techniques such as bag-and-mask ventilation with cricoid pressure or a laryngeal mask airway with cricoid pressure should be adopted until oral intubation with in-line traction is performed.