Miner James R, Rubin John, Clark Jacob, Reardon Robert F
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
J Emerg Med. 2015 Dec;49(6):864-7. doi: 10.1016/j.jemermed.2015.07.027. Epub 2015 Sep 26.
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.
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.
气管插管喉罩气道（ILMA）是一种声门外装置，通气和氧合成功率高。大多数现代气道管理方案建议在紧急气道管理中，将声门外装置作为气道失败时的一线抢救技术。最终，如果声门外临时装置效果良好，则需要建立更安全的气道。逆行插管是一种手术气道管理技术，有效但相对较慢，在操作过程中能够维持通气时最为有用。
我们报告2例紧急气道管理困难的病例，最初使用ILMA，随后使用逆行插管建立更安全的气道。
急诊医生为何应了解这一点？：在进行复杂气道管理时，可在喉罩在位的情况下进行逆行插管。
