title: Retrograde Intubation with an Extraglottic Device in Place.
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.
  
  
  METHODS
  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.
authors.affiliation: Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
authors.forename: James R
authors.initials: JR
authors.lastname: Miner
authors.affiliation: Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
authors.forename: John
authors.initials: J
authors.lastname: Rubin
authors.affiliation: Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
authors.forename: Jacob
authors.initials: J
authors.lastname: Clark
authors.affiliation: Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Reardon
mesh_terms: D058109:Airway Management / Q000295:instrumentation*; D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy*; D000465:Algorithms; D006259:Craniocerebral Trauma / Q000628:therapy*; D017809:Fatal Outcome; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D017214:Laryngeal Masks; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: airway; intubating laryngeal mask; retrograde intubation