Numerous online guides are available for awake tracheal intubations, including detailed breakdowns of specific equipment and techniques. This post is aimed to share my personal approach to ATI Further information can be found at AAGBI and DAS
Max lidocaine dose: 9mg/kg LBW co-phenylcaine ( 125mg ) spray to turbinates of selected nostril 2% lidocaine ( 5ml, 100mg ) via MAD in selected nostril 10% lidocaine ( 10x sprays, 100mg ) via atomiser to oropharynx 2% lidocaine ( 5ml, 100mg ) in 5ml syringe via MADgic x2-3 Check for successful topicalisation with suction catheter Optional Final topicalisation when vocal cords directly in view of scope Reassure patient throughout each step of procedure Encourage gargling and swallowing of local anaesthetic, instead of spitting
(3+1) attempts Anaesthesia induced only after two-point check of tracheal tube position (visual confirmation + capnography)