Thanks Karim

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Evening all. I would like to ask the group there opinion on how they feel
about nasal intubations pre-hospital in the trauma setting?  In my region,
in Massachusetts we are about 22 min away from a level 1 trauma center at
almost any given time.  On board, we do carry Hurricane spray along with
affrin to vasoconstrict the nares.  Usually a 6.0 ID or a 6.5 would do the
job with a little more air in the cuff than normally used.  (About 12m/L of
air) and liberal use of lidocane jelly.      
    I'm particularly interested in closed or open head trauma.  However if
you have any type input on this subject then I would certainly welcome it.
Also Dr. Gross, I believe that you flew, or still work on a medical rescue
helicopter.  What was your experience when you encountered someone that was
nasotracheal intubated?
     Sincearly,

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