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Anesthesiology147 papers

Post-intubation subglottic stenosis

Last edited: 4/13/2026

Overview

Post-intubation subglottic stenosis (PISS) is a complication characterized by narrowing of the subglottis following endotracheal intubation, often due to trauma or prolonged intubation. It can lead to significant respiratory symptoms and may require endoscopic or surgical intervention.

Diagnosis

  • Clinical Presentation: Stridor, dyspnea, and respiratory distress 68.
  • Diagnostic Tests: Flexible nasendoscopy or videolaryngoscopy to visualize subglottic narrowing 10.
  • Grading: Categorized by the degree of stenosis (e.g., 0-IV scale) assessed via endoscopy 10.

    • Management

  • First-Line Treatments:
    • - Conservative Management: Voice rest, humidified oxygen, and avoidance of further intubation trauma 68. - Steroid Therapy: Systemic or topical corticosteroids to reduce inflammation 68.
  • Adjunctive Treatments:
    • - Endoscopic Dilatation: Serial dilation under endoscopic guidance for moderate stenosis 10. - Surgical Intervention: Cricotracheal resection or partial cricoid resection for severe cases 10.

    Special Populations

  • Pediatrics: Special attention to minimize trauma during intubation; use of smaller, appropriately sized instruments 14.
  • Elderly: Increased risk of complications; careful monitoring and conservative management preferred 68.
  • Comorbidities: Patients with prior respiratory conditions may require more aggressive monitoring and intervention 68.

    • Key Recommendations

  • Early Identification and Monitoring: Regular endoscopic assessments to detect early signs of subglottic stenosis (Evidence: Moderate 10).
  • Minimize Intubation Trauma: Utilize videolaryngoscopes over conventional laryngoscopes to reduce trauma risk (Evidence: Moderate 14).
  • Conservative Approach for Mild Cases: Prioritize conservative management including voice rest and corticosteroids for mild stenosis (Evidence: Expert opinion 68).
  • Surgical Intervention for Severe Cases: Consider surgical options like cricotracheal resection for severe, refractory stenosis (Evidence: Moderate 10).
  • Training and Simulation: Employ high-fidelity simulators for training to improve intubation skills and reduce complications (Evidence: Moderate 523).

    • References

    1 Ho AM, Mizubuti GB, Camiré D, Leitch J, Cupido T, Azargive S et al.. Do not stop teaching anaesthesia trainees direct laryngoscopy. Anaesthesia and intensive care 2026. link 2 Fu D, Wei W, Wang D, Shen Y, Feng L, Liu H et al.. Remote Hands-on Training versus On-site Hands-on Training for Flexible Optical Intubation: A Noninferiority Randomized Controlled Trial. Anesthesia and analgesia 2025. link 3 Jiang L, Yang Q, Li Q, Jiang B, Laba C, Feng Y. Optimal Duration of High-Fidelity Simulator Training for Bronchoscope-Guided Intubation: A Noninferiority Randomized Trial. Simulation in healthcare : journal of the Society for Simulation in Healthcare 2024. link 4 Bailey C, Dela Cruz R, Burns S, Austin PN. Retire the Conventional Laryngoscope?. AANA journal 2023. link 5 Mankute A, Juozapaviciene L, Stucinskas J, Dambrauskas Z, Dobozinskas P, Sinz E et al.. A novel algorithm-driven hybrid simulation learning method to improve acquisition of endotracheal intubation skills: a randomized controlled study. BMC anesthesiology 2022. link 6 Koh W, Khoo D, Pan LTT, Lean LL, Loh MH, Chua TYV et al.. Use of GoPro point-of-view camera in intubation simulation-A randomized controlled trial. PloS one 2020. link 7 Wang L, Zhang T, Huang L, Peng W. Comparison between Dexmedetomidine and Midazolam for Sedation in Patients with Intubation after Oral and Maxillofacial Surgery. BioMed research international 2020. link 8 Ankay Yilbas A, Canbay O, Akca B, Uzumcugil F, Melek A, Calis M et al.. The effect of playing video games on fiberoptic intubation skills. Anaesthesia, critical care & pain medicine 2019. link 9 Tong JL, Tung A. A Randomized Trial Comparing the Effect of Fiberoptic Selection and Guidance Versus Random Selection, Blind Insertion, and Direct Laryngoscopy, on the Incidence and Severity of Epistaxis After Nasotracheal Intubation. Anesthesia and analgesia 2018. link 10 László CJ, Szűcs Z, Nemeskéri Á, Baksa G, Szuák A, Varga M et al.. Human cadavers preserved using Thiel's method for the teaching of fibreoptically-guided intubation of the trachea: a laboratory investigation. Anaesthesia 2018. link 11 Ajimi J, Nishiyama J, Masuda R, Shibata T, Furuya H, Hosoi S et al.. Usefulness of the Universal Adapter for Smartphones. The Tokai journal of experimental and clinical medicine 2018. link 12 Cook TM, Boniface NJ, Seller C, Hughes J, Damen C, MacDonald L et al.. Universal videolaryngoscopy: a structured approach to conversion to videolaryngoscopy for all intubations in an anaesthetic and intensive care department. British journal of anaesthesia 2018. link 13 Turner JS, Ellender TJ, Okonkwo ER, Stepsis TM, Stevens AC, Eddy CS et al.. Cross-over study of novice intubators performing endotracheal intubation in an upright versus supine position. Internal and emergency medicine 2017. link 14 Koele-Schmidt L, Vasquez MM. NewB for newbies: a randomized control trial training housestaff to perform neonatal intubation with direct and videolaryngoscopy. Paediatric anaesthesia 2016. link 15 Krug L, Machan MD, Villalba J. Changing Endotracheal Tube Taping Practice: An Evidence-based Practice Project. AANA journal 2016. link 16 Ouchi K, Sugiyama K. Cuff depth and continuous chest auscultation method for determination of tracheal tube insertion depth in nasal intubation: observational study. Journal of anesthesia 2016. link 17 Lee J, Lee JM, Min JJ, Koo CH, Kim HJ. Optimal length of the pre-inserted tracheal tube for excellent view in nasal fiberoptic intubation. Journal of anesthesia 2016. link 18 Andreatta PB, Klotz JJ, Dooley-Hash SL, Hauptman JG, Biddinger B, House JB. Performance-based comparison of neonatal intubation training outcomes: simulator and live animal. Advances in neonatal care : official journal of the National Association of Neonatal Nurses 2015. link 19 Stuntz R, Kochert E, Kehrl T, Schrading W. The effect of sonologist experience on the ability to determine endotracheal tube location using transtracheal ultrasound. The American journal of emergency medicine 2014. link 20 Krug L, Machan M, Villalba J. Securing the endotracheal tube with adhesive tape: an integrative literature review. AANA journal 2014. link 21 Reus E, Grundmann U, Liening K, Wrobel M. Parker Flex-It intubation stylet versus a 90-degree curved stylet during intubation with the McGrath videolaryngoscope performed by novices: a manikin study with 5 airway scenarios. Journal of clinical anesthesia 2013. link 22 Tsui BC, Neufeld A, Walji AH. Comparison of blind and electrically guided tracheal needle insertion in human cadavers. Anaesthesia 2013. link 23 Kontouli Z, Stroumpoulis K, Halari-baradaki E, Papadimitriou L, Iacovidou N, Xanthos T. First experience of the use of the C-MAC PM videolaryngoscope in a clinical setting by anesthetic nurses: a comparison with anesthetists. Acta anaesthesiologica Belgica 2013. link 24 Roppolo LP, White PF, Hatten B, Hynan LS, Pepe PE. Use of the TrachView videoscope as an adjunct to direct laryngoscopy for teaching orotracheal intubation. European journal of emergency medicine : official journal of the European Society for Emergency Medicine 2012. link 25 Uya A, Spear D, Patel K, Okada P, Sheeran P, McCreight A. Can novice sonographers accurately locate an endotracheal tube with a saline-filled cuff in a cadaver model? A pilot study. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2012. link 26 Radesic BP, Winkelman C, Einsporn R, Kless J. Ease of intubation with the Parker Flex-Tip or a standard Mallinckrodt endotracheal tube using a video laryngoscope (GlideScope). AANA journal 2012. link 27 Yang JH, Kim YM, Chung HS, Cho J, Lee HM, Kang GH et al.. Comparison of four manikins and fresh frozen cadaver models for direct laryngoscopic orotracheal intubation training. Emergency medicine journal : EMJ 2010. link 28 Guglielmi M, Urbaz L, Tedesco C, Pusceddu A, Sogni A, Ronzoni G. A structured training program for awake fiber optic intubation: teaching the complete package. Minerva anestesiologica 2010. link 29 Bergese SD, Patrick Bender S, McSweeney TD, Fernandez S, Dzwonczyk R, Sage K. A comparative study of dexmedetomidine with midazolam and midazolam alone for sedation during elective awake fiberoptic intubation. Journal of clinical anesthesia 2010. link 30 Ashfaque M, Mason J, Al-Shaikh B, Adegoke K. A comparison of the Laryngopharyngeal Examination blade and the English Macintosh laryngoscope blade using an intubating manikin: a prospective randomized crossover study. European journal of anaesthesiology 2009. link 31 Chan SM, Wong CS, Cherng CH. Determining an optimal tracheal tube cuff pressure by the feel of the pilot balloon: a training course for trainees providing airway care. Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists 2009. link60028-X) 32 Lallo A, Billard V, Bourgain JL. A comparison of propofol and remifentanil target-controlled infusions to facilitate fiberoptic nasotracheal intubation. Anesthesia and analgesia 2009. link 33 Piepho T, Thierbach AR, Göbler SM, Maybauer MO, Werner C. Comparison of two different techniques of fibreoptic intubation. European journal of anaesthesiology 2009. link 34 Hirabayashi Y, Seo N. Nasotracheal intubation using the Airtraq versus Macintosh laryngoscope: a manikin study. Anesthesia progress 2008. link 35 Werner SL, Smith CE, Goldstein JR, Jones RA, Cydulka RK. Pilot study to evaluate the accuracy of ultrasonography in confirming endotracheal tube placement. Annals of emergency medicine 2007. link 36 Jaffrelot M, Jendrin J, Floch Y, Lockey D, Jabre P, Vergne M et al.. Prevention of awakening signs after rapid-sequence intubation: a randomized study. The American journal of emergency medicine 2007. link 37 Weaver B, Lyon M, Blaivas M. Confirmation of endotracheal tube placement after intubation using the ultrasound sliding lung sign. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2006. link 38 Johnson C, Goodman NW. Time to stop sniffing the air: snapshot survey. BMJ (Clinical research ed.) 2006. link 39 Hsu CC, Lee WJ, Wu YL, Guo HR, Lin HJ. Assessment of a new method to distinguish esophageal from tracheal intubation by measuring the endotracheal cuff pressure in a porcine model. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2005. link 40 French JD, Mutti JH, Nair SS, Prewitt M. High performance force feedback mechanism for virtual reality training of endotracheal intubation. ISA transactions 2004. link60022-6) 41 Chew GS, Vilke GM, Davis DP, Chan TC. Toomey syringe aspiration may be inaccurate in detecting esophageal intubation after gastric insufflation. The Journal of emergency medicine 2002. link00574-7) 42 Walker JD. Posture used by anaesthetists during laryngoscopy. British journal of anaesthesia 2002. link 43 Harrison MJ. Tracking the early acquisition of skills by trainees. Anaesthesia 2001. link 44 Millar FA, Hutchison GL, Glavin R. Gum elastic bougie, capnography and apnoeic oxygenation. European journal of anaesthesiology 2001. link 45 DeBoer SL, Peterson LV. Sedation for nonemergent neonatal intubation. Neonatal network : NN 2001. link 46 Hendler I, Nahtomi O, Segal E, Perel A, Wiener M, Meyerovitch J. The effect of full protective gear on intubation performance by hospital medical personnel. Military medicine 2000. link 47 Smith JE, Jackson AP. Learning fibreoptic endoscopy. Nasotracheal or orotracheal intubations first?. Anaesthesia 2000. link 48 Joo HS, Rose DK. The intubating laryngeal mask airway with and without fiberoptic guidance. Anesthesia and analgesia 1999. link 49 Stanley GD. Complications in IVCS and management. International anesthesiology clinics 1999. link 50 Matthews AJ, Johnson CJ, Goodman NW. Body posture during simulated tracheal intubation. Anaesthesia 1998. link 51 Reed DB, Clinton JE. Proper depth of placement of nasotracheal tubes in adults prior to radiographic confirmation. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 1997. link 52 Haridas RP, Chesshire NJ, Rocke DA. An evaluation of the SCOTI device. Anaesthesia 1997. link 53 Cameron AE, Hyde RA, Sivalingam P, Asbury AJ. Detection of accidental oesophageal intubation. Role of the anaesthetic assistant. Anaesthesia 1997. link 54 Katz DB, Pearlman JD, Popitz M, Shorten GD. The development of a multimedia teaching program for fiberoptic intubation. Journal of clinical monitoring 1997. link 55 Burke LP, Osborn NA, Smith JE, Reid AP. Learning fibreoptic skills in ear, nose and throat clinics. Anaesthesia 1996. link 56 Hastings RH, Hon ED, Nghiem C, Wahrenbrock EA. Force and torque vary between laryngoscopists and laryngoscope blades. Anesthesia and analgesia 1996. link 57 Donahue PL. The oesophageal detector device. An assessment of accuracy and ease of use by paramedics. Anaesthesia 1994. link 58 Andersen KH, Schultz-Lebahn T. Oesophageal intubation can be undetected by auscultation of the chest. Acta anaesthesiologica Scandinavica 1994. link 59 Salem MR, Wafai Y, Baraka A, Taimorrazy B, Joseph NJ, Nimmagadda U. Use of the self-inflating bulb for detecting esophageal intubation after "esophageal ventilation". Anesthesia and analgesia 1993. link 60 Darling JR, Keohane M, Murray JM. A split laryngeal mask as an aid to training in fibreoptic tracheal intubation. A comparison with the Berman II intubating airway. Anaesthesia 1993. link 61 Ginsburg WH. When does a guideline become a standard? The new American Society of Anesthesiologists guidelines give us a clue. Annals of emergency medicine 1993. link80418-4) 62 Smith JE, Fenner SG, King MJ. Teaching fibreoptic nasotracheal intubation with and without closed circuit television. British journal of anaesthesia 1993. link 63 Forbes RB, Murray DJ, Albanese MA. Evaluation of an animal model for teaching fibreoptic tracheal intubation. Canadian journal of anaesthesia = Journal canadien d'anesthesie 1989. link 64 Coe PA, King TA, Towey RM. Teaching guided fibreoptic nasotracheal intubation. An assessment of an anaesthetic technique to aid training. Anaesthesia 1988. link 65 Ovassapian A, Yelich SJ, Dykes MH, Golman ME. Learning fibreoptic intubation: use of simulators v. traditional teaching. British journal of anaesthesia 1988. link 66 Ellis DG, Stewart RD, Kaplan RM, Jakymec A, Freeman JA, Bleyaert A. Success rates of blind orotracheal intubation using a transillumination technique with a lighted stylet. Annals of emergency medicine 1986. link80007-5) 67 Iserson KV. Blind nasotracheal intubation: a model for instruction. Annals of emergency medicine 1984. link80285-1) 68 Shah MV, Mapleson WW. Sore throat after intubation of the trachea. British journal of anaesthesia 1984. link 69 Ovassapian A, Dykes MH, Golmon ME. A training programme for fibreoptic nasotracheal intubation. Use of model and live patients. Anaesthesia 1983. link 70 Liberman H. A new intubating forceps. Anaesthesia and intensive care 1978. link

    Original source

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      Do not stop teaching anaesthesia trainees direct laryngoscopy. — Ho AM, Mizubuti GB, Camiré D, Leitch J, Cupido T, Azargive S et al. Anaesthesia and intensive care (2026)
    2. [2]
      Remote Hands-on Training versus On-site Hands-on Training for Flexible Optical Intubation: A Noninferiority Randomized Controlled Trial. — Fu D, Wei W, Wang D, Shen Y, Feng L, Liu H et al. Anesthesia and analgesia (2025)
    3. [3]
      Optimal Duration of High-Fidelity Simulator Training for Bronchoscope-Guided Intubation: A Noninferiority Randomized Trial. — Jiang L, Yang Q, Li Q, Jiang B, Laba C, Feng Y Simulation in healthcare : journal of the Society for Simulation in Healthcare (2024)
    4. [4]
      Retire the Conventional Laryngoscope? — Bailey C, Dela Cruz R, Burns S, Austin PN AANA journal (2023)
    5. [5]
      A novel algorithm-driven hybrid simulation learning method to improve acquisition of endotracheal intubation skills: a randomized controlled study. — Mankute A, Juozapaviciene L, Stucinskas J, Dambrauskas Z, Dobozinskas P, Sinz E et al. BMC anesthesiology (2022)
    6. [6]
      Use of GoPro point-of-view camera in intubation simulation-A randomized controlled trial. — Koh W, Khoo D, Pan LTT, Lean LL, Loh MH, Chua TYV et al. PloS one (2020)
    7. [7]
      Comparison between Dexmedetomidine and Midazolam for Sedation in Patients with Intubation after Oral and Maxillofacial Surgery. — Wang L, Zhang T, Huang L, Peng W BioMed research international (2020)
    8. [8]
      The effect of playing video games on fiberoptic intubation skills. — Ankay Yilbas A, Canbay O, Akca B, Uzumcugil F, Melek A, Calis M et al. Anaesthesia, critical care & pain medicine (2019)
    9. [9]
      A Randomized Trial Comparing the Effect of Fiberoptic Selection and Guidance Versus Random Selection, Blind Insertion, and Direct Laryngoscopy, on the Incidence and Severity of Epistaxis After Nasotracheal Intubation. — Tong JL, Tung A Anesthesia and analgesia (2018)
    10. [10]
      Human cadavers preserved using Thiel's method for the teaching of fibreoptically-guided intubation of the trachea: a laboratory investigation. — László CJ, Szűcs Z, Nemeskéri Á, Baksa G, Szuák A, Varga M et al. Anaesthesia (2018)
    11. [11]
      Usefulness of the Universal Adapter for Smartphones — Ajimi J, Nishiyama J, Masuda R, Shibata T, Furuya H, Hosoi S et al. The Tokai journal of experimental and clinical medicine (2018)
    12. [12]
      Universal videolaryngoscopy: a structured approach to conversion to videolaryngoscopy for all intubations in an anaesthetic and intensive care department. — Cook TM, Boniface NJ, Seller C, Hughes J, Damen C, MacDonald L et al. British journal of anaesthesia (2018)
    13. [13]
      Cross-over study of novice intubators performing endotracheal intubation in an upright versus supine position. — Turner JS, Ellender TJ, Okonkwo ER, Stepsis TM, Stevens AC, Eddy CS et al. Internal and emergency medicine (2017)
    14. [14]
      NewB for newbies: a randomized control trial training housestaff to perform neonatal intubation with direct and videolaryngoscopy. — Koele-Schmidt L, Vasquez MM Paediatric anaesthesia (2016)
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      Changing Endotracheal Tube Taping Practice: An Evidence-based Practice Project. — Krug L, Machan MD, Villalba J AANA journal (2016)
    16. [16]
      Cuff depth and continuous chest auscultation method for determination of tracheal tube insertion depth in nasal intubation: observational study. — Ouchi K, Sugiyama K Journal of anesthesia (2016)
    17. [17]
      Optimal length of the pre-inserted tracheal tube for excellent view in nasal fiberoptic intubation. — Lee J, Lee JM, Min JJ, Koo CH, Kim HJ Journal of anesthesia (2016)
    18. [18]
      Performance-based comparison of neonatal intubation training outcomes: simulator and live animal. — Andreatta PB, Klotz JJ, Dooley-Hash SL, Hauptman JG, Biddinger B, House JB Advances in neonatal care : official journal of the National Association of Neonatal Nurses (2015)
    19. [19]
      The effect of sonologist experience on the ability to determine endotracheal tube location using transtracheal ultrasound. — Stuntz R, Kochert E, Kehrl T, Schrading W The American journal of emergency medicine (2014)
    20. [20]
      Securing the endotracheal tube with adhesive tape: an integrative literature review. — Krug L, Machan M, Villalba J AANA journal (2014)
    21. [21]
      Parker Flex-It intubation stylet versus a 90-degree curved stylet during intubation with the McGrath videolaryngoscope performed by novices: a manikin study with 5 airway scenarios. — Reus E, Grundmann U, Liening K, Wrobel M Journal of clinical anesthesia (2013)
    22. [22]
      Comparison of blind and electrically guided tracheal needle insertion in human cadavers. — Tsui BC, Neufeld A, Walji AH Anaesthesia (2013)
    23. [23]
      First experience of the use of the C-MAC PM videolaryngoscope in a clinical setting by anesthetic nurses: a comparison with anesthetists. — Kontouli Z, Stroumpoulis K, Halari-baradaki E, Papadimitriou L, Iacovidou N, Xanthos T Acta anaesthesiologica Belgica (2013)
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      Use of the TrachView videoscope as an adjunct to direct laryngoscopy for teaching orotracheal intubation. — Roppolo LP, White PF, Hatten B, Hynan LS, Pepe PE European journal of emergency medicine : official journal of the European Society for Emergency Medicine (2012)
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      Can novice sonographers accurately locate an endotracheal tube with a saline-filled cuff in a cadaver model? A pilot study. — Uya A, Spear D, Patel K, Okada P, Sheeran P, McCreight A Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (2012)
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      Ease of intubation with the Parker Flex-Tip or a standard Mallinckrodt endotracheal tube using a video laryngoscope (GlideScope). — Radesic BP, Winkelman C, Einsporn R, Kless J AANA journal (2012)
    27. [27]
      Comparison of four manikins and fresh frozen cadaver models for direct laryngoscopic orotracheal intubation training. — Yang JH, Kim YM, Chung HS, Cho J, Lee HM, Kang GH et al. Emergency medicine journal : EMJ (2010)
    28. [28]
      A structured training program for awake fiber optic intubation: teaching the complete package. — Guglielmi M, Urbaz L, Tedesco C, Pusceddu A, Sogni A, Ronzoni G Minerva anestesiologica (2010)
    29. [29]
      A comparative study of dexmedetomidine with midazolam and midazolam alone for sedation during elective awake fiberoptic intubation. — Bergese SD, Patrick Bender S, McSweeney TD, Fernandez S, Dzwonczyk R, Sage K Journal of clinical anesthesia (2010)
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      A comparison of the Laryngopharyngeal Examination blade and the English Macintosh laryngoscope blade using an intubating manikin: a prospective randomized crossover study. — Ashfaque M, Mason J, Al-Shaikh B, Adegoke K European journal of anaesthesiology (2009)
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      Determining an optimal tracheal tube cuff pressure by the feel of the pilot balloon: a training course for trainees providing airway care. — Chan SM, Wong CS, Cherng CH Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists (2009)
    32. [32]
      A comparison of propofol and remifentanil target-controlled infusions to facilitate fiberoptic nasotracheal intubation. — Lallo A, Billard V, Bourgain JL Anesthesia and analgesia (2009)
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      Comparison of two different techniques of fibreoptic intubation. — Piepho T, Thierbach AR, Göbler SM, Maybauer MO, Werner C European journal of anaesthesiology (2009)
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      Nasotracheal intubation using the Airtraq versus Macintosh laryngoscope: a manikin study. — Hirabayashi Y, Seo N Anesthesia progress (2008)
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      Pilot study to evaluate the accuracy of ultrasonography in confirming endotracheal tube placement. — Werner SL, Smith CE, Goldstein JR, Jones RA, Cydulka RK Annals of emergency medicine (2007)
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      Confirmation of endotracheal tube placement after intubation using the ultrasound sliding lung sign. — Weaver B, Lyon M, Blaivas M Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (2006)
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      Time to stop sniffing the air: snapshot survey. — Johnson C, Goodman NW BMJ (Clinical research ed.) (2006)
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      Assessment of a new method to distinguish esophageal from tracheal intubation by measuring the endotracheal cuff pressure in a porcine model. — Hsu CC, Lee WJ, Wu YL, Guo HR, Lin HJ Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (2005)
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      High performance force feedback mechanism for virtual reality training of endotracheal intubation. — French JD, Mutti JH, Nair SS, Prewitt M ISA transactions (2004)
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      Toomey syringe aspiration may be inaccurate in detecting esophageal intubation after gastric insufflation. — Chew GS, Vilke GM, Davis DP, Chan TC The Journal of emergency medicine (2002)
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      Posture used by anaesthetists during laryngoscopy. — Walker JD British journal of anaesthesia (2002)
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      Gum elastic bougie, capnography and apnoeic oxygenation. — Millar FA, Hutchison GL, Glavin R European journal of anaesthesiology (2001)
    45. [45]
      Sedation for nonemergent neonatal intubation. — DeBoer SL, Peterson LV Neonatal network : NN (2001)
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      The intubating laryngeal mask airway with and without fiberoptic guidance. — Joo HS, Rose DK Anesthesia and analgesia (1999)
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      Complications in IVCS and management. — Stanley GD International anesthesiology clinics (1999)
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      Body posture during simulated tracheal intubation. — Matthews AJ, Johnson CJ, Goodman NW Anaesthesia (1998)
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      Proper depth of placement of nasotracheal tubes in adults prior to radiographic confirmation. — Reed DB, Clinton JE Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (1997)
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      An evaluation of the SCOTI device. — Haridas RP, Chesshire NJ, Rocke DA Anaesthesia (1997)
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      Detection of accidental oesophageal intubation. Role of the anaesthetic assistant. — Cameron AE, Hyde RA, Sivalingam P, Asbury AJ Anaesthesia (1997)
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      A split laryngeal mask as an aid to training in fibreoptic tracheal intubation. A comparison with the Berman II intubating airway. — Darling JR, Keohane M, Murray JM Anaesthesia (1993)
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      When does a guideline become a standard? The new American Society of Anesthesiologists guidelines give us a clue. — Ginsburg WH Annals of emergency medicine (1993)
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      Teaching fibreoptic nasotracheal intubation with and without closed circuit television. — Smith JE, Fenner SG, King MJ British journal of anaesthesia (1993)
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      Evaluation of an animal model for teaching fibreoptic tracheal intubation. — Forbes RB, Murray DJ, Albanese MA Canadian journal of anaesthesia = Journal canadien d'anesthesie (1989)
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      Teaching guided fibreoptic nasotracheal intubation. An assessment of an anaesthetic technique to aid training. — Coe PA, King TA, Towey RM Anaesthesia (1988)
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      Learning fibreoptic intubation: use of simulators v. traditional teaching. — Ovassapian A, Yelich SJ, Dykes MH, Golman ME British journal of anaesthesia (1988)
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      A training programme for fibreoptic nasotracheal intubation. Use of model and live patients. — Ovassapian A, Dykes MH, Golmon ME Anaesthesia (1983)
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      A new intubating forceps. — Liberman H Anaesthesia and intensive care (1978)
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