Awake iintubation may involve:
(1) fiberoptics (awake fiberoptic intubation or AFOI)
(2) video laryngoscopy
(3) direct laryngoscopy
(4) other (blind nasal inubation, intubating laryngeal mask, etc)
Reasons to consider awake intubation:
(1) difficult mask ventilation
(2) difficult tracheal intubation
Absolute contraindications:
(1) patient refusal to consent (after adequate counseling)
(2) patient uncooperative
Relative contraindications:
(1) operator inexperience
(2) lack of adequate equipment
(3) allergy to local anesthetic
(4) active hemorrhage into the airway, sufficient to obscure procedure
Caution (may require an expert):
(1) upper airway tumor
(2) other conditions associated with risk for total airway obstruction
