Retrograde Intubation with an Extraglottic Device in Place

• 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
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2015.07.027

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.