Consider awake BNTI in a predicted difficult airway
start with 32 french trumpet anesthetize through it to get post pharynx
Use the left nostril or if using the right turn tube 180°
Facilitated by neutral head position and ET tube cuff inflation to 15cc.
depth is 26-28 cm at nares
aim towards contralateral nipple
Levitan’s Excellent Review Article
Intubation was originally done with soft rubber tubes, much less likely to cause trauma