Lesson 18: Retrograde Intubation

Retrograde Intubation Overview

• Blind procedure for tracheal intubation using an endotracheal tube over a wire.

Indications

• Unstable cervical spine (most common use).
• Upper airway bleeding (when visualization is not possible).
• Suitable for situations where traditional intubation has failed but ventilation is still possible.
• Can be performed in awake patients.

Contraindications

• Poor anatomy (e.g., neck deformities, neck mass).
• Laryngotracheal disease (e.g., tracheal stenosis, obstructive tumor).
• Coagulopathy or infection (e.g., pretracheal abscess).

Complications

• Bleeding, pneumomediastinum, pneumothorax,
• Trigeminal nerve trauma, breath-holding.
• Potential for wire misdirection.