The most common complication associated with endonasal intubation is epistaxis due to nasal abrasion, most commonly in the anterior part of the nasal septum, which can range from mild blood tinged mucus to massive epistaxis (Tintinalli, O'Connell, Hall). The risk of epistaxis increases with the use of excessive force, large endotracheal tube, repeated unsuccessful attempts and abnormal pharyngeal anatomy (Hall ). Rarer complications of nasal intubation include traumatic avulsion of the turbinates, turbinate fracture, retro pharyngeal laceration, and bacteremia (Williams, Hall, Dinner).