Among the least commonly utilized intubation techniques stands the humble digital intubation. The name says it all: the intubator uses their index and middle finger like a miller blade to locate (by palpation) and lift the epiglottis before gliding the ETT between the fingers into the trachea. More commonly utilized in pre-hospital and tactical situations, there is decent existing evidence for the technique as a failed airway maneuver for paramedic and as an easily-learned proecdure by emergency medicine residents. Advantages of the technique include speed, minimal need for positioning or c-spine movements and ability to perform blind. Disadvantages include need for practice, potential trauma to patient and provider, and the necessity of the patient being paralyzed or comatose.
Regardless, a worthwhile technique to at least be aware of in your next difficult airway. Illustrations of how to perform are below.
Young SE, Miller MA, Crystal CS, Skinner C, Coon TP. Is digital intubation an option for emergency physicians in definitive airway management? Am J Emerg Med. 2006 Oct;24(6):729-32. PubMed PMID: 16984845.