Retrograde Intubation with an Extraglottic Device in Place

Abstract Background The intubating laryngeal mask airway (ILMA) is an extraglottic device with a high rate of successful ventilation and oxygenation. Most modern airway algorithms suggest using an extraglottic device as the first-line rescue technique for a failed airway in emergency airway manageme...

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Bibliographic Details
Published in:The Journal of emergency medicine 2015-12, Vol.49 (6), p.864-867
Main Authors: Miner, James R., MD, Rubin, John, Clark, Jacob, Reardon, Robert F., MD
Format: Article
Language:English
Subjects:
airway
Airway Management - instrumentation
Airway Obstruction - etiology
Airway Obstruction - therapy
Algorithms
Craniocerebral Trauma - therapy
Emergency
Fatal Outcome
Humans
intubating laryngeal mask
Intubation, Intratracheal - instrumentation
Laryngeal Masks
Laryngoscopy
Male
Middle Aged
retrograde intubation
Young Adult
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Description
Summary:Abstract Background The intubating laryngeal mask airway (ILMA) is an extraglottic device with a high rate of successful ventilation and oxygenation. Most modern airway algorithms suggest using an extraglottic device as the first-line rescue technique for a failed airway in emergency airway management. Eventually, a more secure airway is needed if the extraglottic temporizing device is working well. Retrograde intubation is a surgical airway management technique that is effective but relatively slow, making it most useful when ventilation can be maintained during the procedure. Case Report We report 2 cases of difficult emergency airway management with an ILMA used initially and retrograde intubation later used to establish a more secure airway. Why Should an Emergency Physician Be Aware of This? Retrograde incubation can be performed with an LMA in place for complicated airway management.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2015.07.027