Nasal intubation (Magill Forceps)

Last updated: February 9, 2026

1. Assess which naris is more patent. Apply oxymetazoline (Afrin) to both nares. Lubricate and gently dilate the chosen naris with progressively larger nasal trumpets.
2. Insert the nasal RAE tube. Start with a size similar to the planned oral ETT, or downsize by 0.5–1.0 mm based on patient height and naris size.
3. Perform laryngoscopy (preferably video) to visualize the cords. Using Magill forceps, grasp the tube proximal to the cuff (avoid the cuff to prevent rupture) and guide the tip through the vocal cords under direct visualization.
   1. Optional: use a red rubber catheter as a guide. seat the ETT tip into the catheter and advance the catheter through the nose into the oropharynx to help direct the tube into the pharynx.