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Retrograde intubation: a viable option in the management of the difficult airway?
Thesis

Retrograde intubation: a viable option in the management of the difficult airway?

Susan Monti
Master of Science (M.S.), Medical College of Pennsylvania
Mar 1994
DOI:
https://doi.org/10.17918/00007458
pdf
Monti_Susan_19941.93 MB
PDF Access upon request, Email title, URL, or DOI to archives@drexel.edu

Abstract

Emergency medicine Anesthesiology
Objective: To examine the performance of retrograde tracheal intubation (RTI), by persons inexperienced in the technique. Methods: This was a prospective cases series of RTI performed by Emergency Medicine Residents, CRNA's (Certified Registered Nurse Anesthesists, and SRNA's (Student Registered Nurse Anesthesists. After family consent, the participant made a single attempt at RTI, in a newly dead (less than 3 hrs.) adult patient. Differences in the performances of the EM residents and the Anesthesia personnel were compared using chi-square analysis and Fisher t-tests. Significance was set at P 0.05. Results: There were 18 participants who attempted 27 times. Prior to the study, only 2 had attempted RTI, and 72% had no experience in this procedure. The success rate overall was 82% (provided you excluded the time criteria). The success rate improved from 72% (13 of 18) on the first study attempt to 100% (9 of 9) for subsequent attempts. The overall mean time to achieve successful endotracheal tube placement was 189 seconds. Success rates for EM Residents and Anesthesia personnel were similar (83% vs 78%), however EM residents performed RTI more rapidly, (152 sec vs 268 sec, p 0.04). Conclusion: Inexperience operators can perform retrograde intubation with a high rate of success, in less than 5 minutes.

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