 Tracheal intubation in the emergency setting can be difficult with the fiberoptic bronchoscope due to blood , vomit , or secretions in the airway and poor patient cooperation . Because of this , patients with massive facial injury , complete upper airway obstruction , severely diminished ventilation , or profuse upper airway bleeding are poor candidates for fiberoptic intubation . <unk> intubation under general anesthesia typically requires two skilled individuals . Success rates of only 83 – 87 % have been reported using fiberoptic techniques in the emergency department , with significant nasal bleeding occurring in up to 22 % of patients . These drawbacks limit the use of fiberoptic bronchoscopy somewhat in urgent and emergency situations . 
