Podcast 1003: Nasal Intubation

Podcast 1003: Nasal Intubation

From Emergency Medical Minute by Emergency Medical Minute

April 27, 2026 · 9 min

About this episode

This episode discusses nasal intubation, its indications, and how it differs from oral intubation.

Contributor: Alec Coston, MD Educational Pearls: What are nasal intubations and when do we use them? Nasal intubations function similarly to oral intubations with the end goal of passing an endotracheal tube (ETT) through vocal cords and into the trachea to allow for a patent and secure airway, but differ in the main access point for the ETT (nare v.s. mouth). Nasal Intubations are seldom preferred to oral intubations as they carry risk for inducing bleeding from trauma to the nasal passages. Indications for nasal intubations include: Anatomical abnormalities that may make access through the mouth difficult (i.e. tumors, macroglossia, or rare dental hardware that clenches the jaw shut). Physiological states such as severe angioedema. Nasal intubations are often done with the patient awake and could be advantageous if the patient is presenting in a severely hypoxic state such that prolonged hypoxia in a traditional RSI protocol may be detrimental. A 2023 retrospective analysis in Germany found that nasal intubations were associated with requiring less sedation than oral intubations and had more spontaneous breathing during hospitalization than oral intubations. How is a nasal…

People in this episode

Guest: Alec Coston, MD

Topics covered

  • nasal intubation
  • airway management
  • emergency medicine
  • sedation
  • patient care

Keywords

  • nasal intubation
  • oral intubation
  • endotracheal tube
  • airway
  • sedation
  • anatomical abnormalities
  • angioedema
  • patient hypoxia

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