Why Do I Elevate the Head of the Bed for Fiberoptic Intubation?

A few objections I hear a lot in relation to intubating patients in the upright or semi-upright position are: I’m not comfortable elevating the head of the bed after inducing anesthesia.  I’m concerned about hypotension and cerebral perfusion in the head-up position after the induction of anesthesia. I think that underlying this objection is the ingrained bias that all patients …

Why Do I Face the Patient for Fiberoptic Intubation?

Many years ago, I was struggling to intubate a patient endoscopically.  The patient had difficult airway anatomy due to head and neck cancer.  I was standing at the head of the bed, the patient was supine, I couldn’t get the scope around the base of the tongue, and I couldn’t see anything except soft tissue.  The ENT surgeon watched me …

Have I Really Accomplished More Than 6000 Fiberoptic Intubations?

Yes.  Really.  Starting in late October 2004, I kept careful records of all my endoscopic intubations. Taking into account days off—vacation, post-call, holidays, family leave, etc.—I worked about ten months per year and consistently performed well more than 400 endoscopic intubations per year. In mid-June of 2014, I accomplished my 4000th endoscopic intubation.  I calculate this took me about 98 …

Frequently Asked Questions

Below are some of the most common questions received regarding Flexible Fiberoptic Intubation. Have you really accomplished more than 6000 fiberoptic intubations? Yes.  Really.  Starting in October 2004, I kept careful records of all my intubations.  I consistently performed more than 400 endoscopic intubations per year, every year.  In June of 2014, I accomplished my 4000th intubation.  Nothing has changed …