5 Minute Bit #32 - Retrograde Intubation

The retrograde intubation! An oldy but goody and a nice trick to keep in your back pocket.
1. Prep the neck
2. Identify the anatomy and your Cricothyroid membrane
3. Introduce your needle with syringe attached through cricothyroid membrane in a cranial (cephalad) direction. Withdraw plunger and confirm position with whisp of air in syringe (can have saline in syringe to look for bubbles).
4. Pass wire through needle until operator at the head retrieves it with forceps. Continue passing the wire until most is exiting the oral cavity.
5. Clamp wire at the front of the neck with needle holder.
6. 2 operators work to stabilize wire and pass the tube until resistance is met.  Then, unclamp wire and pass tube/pull wire from up top, simultaneously.
7. Inflate cuff, confirm placement.  See video below:

This video utilizes a cook catheter over the wire but the technique is essentially the same, enjoy:

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjao8S40qHuAhXPHM0KHXdeDpUQFjAGegQIAhAC&url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3D4fw0UezAkzk&usg=AOvVaw2ykYSvBB-pQE8ywlDu_bLc


Enjoy these articles about retrograde intubation:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016593/

https://journals.lww.com/johnajournal/fulltext/2019/05000/the_retrograde_tracheal_intubation_technique_for.3.aspx