Use of a guide wire and a ureteral dilator as an aid to awake fibreoptic intubation

We describe the successful use of a guide wire and ureteral dilator to pass a tracheal tube into the trachea through the mouth in an awake, sedated patient when attempts to pass a larger tube over an Olympus LF1 fibreoptic bronchoscope were unsuccessful. Since the ureteral and renal dilators are available in a variety of sizes, if too large a tube is inadvertently mounted on the instrument this technique allows an appropriate sized tube to be inserted without the need to re-endoscope the patient.