Fiber-optic orotracheal intubation during sedation and topical anesthesia. A. After sedation and application of topical anesthesia, an Ovassapian intubating airway is placed, and the oropharynx is suctioned. B. The endotracheal tube is removed from a warm water bath, lubricated, and placed inside the airway. The flexible intubation scope (FIS) is advanced through the endotracheal tube into the oropharynx, under the epiglottis, and inside the trachea. Care should be exercised to avoid passing the FIS through the Murphy eye. C. The endotracheal tube is passed over the FIS into the trachea. The distance between carina and tip of the endotracheal tube is measured using the FIS before it is removed. Source: Airway Management, Anesthesiology, 3e Citation: Longnecker DE, Mackey SC, Newman MF, Sandberg WS, Zapol WM. Anesthesiology, 3e; 2017 Available at: http://accessanesthesiology.mhmedical.com/DownloadImage.aspx?image=/data/books/2152/longnecker3_ch32_f030a.png&sec=164222228&BookID=2152&ChapterSecID=164221970&imagename= Accessed: November 11, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved