Oral intubation with armored tube (prevents kinking)
See technique for preparing tube prior to intubation for easy circuit disconnect
Other:
Examine for gaps in dentition- may obviate need to perform submental intubation
Armamentarium:
Size 5 or 6 regular oral endotracheal tube
6 or 7 armored endotracheal tube
Knife to cut tube from connector
#15 blade
Large hemostat
24g wire if wiring tube to dentition
3-0 chromic gut
5-0 plain gut
Technique
Examine dentition, if there is an edentulous space that may accomodate an oral tube while patient is in maxillomandibular fixation, it may obviate the need to perform a submental intubation
At this stage the tube needs to be secured to prevent dislodgment. Options include dental wiring or suturing to submental skin (shown below)
When reversing the submental, the tube will be pulled through first followed by the cuff
Intra and extraoral incisions can be closed with resorbable/nonresorbable sutures per surgeon preference
