Retrograde Intubation

Rangat

Rangat

Forum Lieutenant
Messages
166
Reaction score
0
Points
0
So, what's the last time you old school CCP's did a retrograde intubation?:)
Successful_Retrograde_Intubation.jpg


Successful pre-hospital retrograde intubation - patient was a passenger in a truck which slammed into the back of another. This guy had some sort of disease of the throat and visualising the cords was just not happening. He didnt want to cryc in case his airway (which looked like a cauliflower down there) bled too much and he still wouldnt get it in.
 
Last edited by a moderator:
I love old school. Usually low tech is the best tech, but I won't retro the dude. If I can't tube 'em or combi 'em, I'll cut 'em. I don't see how you can go retro quickly enough. Nothing against the technique; I just don't see it.
 
With the introduction of the Bougie, there is no need for retrograde anymore. Besides, I've seen too many people screw it up and lacerate things they shouldn't. Created a bloody mess. Like Mike said, you can't tube 'em or drop a Combitube, then Cric or Trach them.........
 
I don't see how you can screw it up? Maybe if you trained a long time ago and your skills are rusty? Didn't do good at anatomy?

Ive only seen them done, but they are VERY smooth, quick, and a lot less harmful than a cricothyroidotomy.

And he said the larynx had the potential to bleed lots, and we all know how difficult it becomes when there is just blood everywhere.
 
Apparently I'm missing something here. Walk me through it from your point of view, step by step, so I am more able to fully understand your definition of "VERY smooth, quick, and a lot less harmful than a cricothyrotomy".
 
what is retrograde intubation? How is different from normal intubation? You can't see the chords so you go in blind?
 
I have performed a few retrograde intubations, and each time except for one I always thought to myself I should had just performed a crich instead.

It is a dangerous and very time consuming procedure, that should be used as a very last measure. There is much more easier, safer measures devices out there as discussed, especially in the field setting. The advances of new crich kits, alternative airways, flex guides (elastic gum bougie), trigger ETT, etc.. retrograde has now been discussed as non-advantageous and no reason to perform especially in prehospital setting.

The only time I justified such was with a patient that had a large goiter, even then reviewing the call I probably should had just performed a surgical airway/trach instead.

We used to teach flight teams the procedures but now have abandoned it for reasons I discussed. It was not because lack of anatomy education or airway education by far (SLAM courses), rather no literature or evidence to document the procedure is frequently warranted in the prehospital arena.

The main emphasis should be placed upon assessing your patient using such acronyms LEMON and sizing your patient prior to intubation.

R/r 911
 
Last edited by a moderator:
I read this thread and that link but still do not understand why it is necesary...
 
You must log in or register to reply here.
Back
Top