Retrograde intubation as I was taught is a technique using a guide wire inserted into the trachea though the cricoid cartridge. and advanced up towards the cords. Once the wire is visualized it is advanced out of the oral pharynx to the point that a oral ETT can be advanced over the wire. One the holds the wire with some hemostats and advances the tube past the cords. This is so rarely used I have only seen it in videos during school. Used with local anesthetics and LIGHT sedation. This is used in the most difficult of airways, and rarely used..
I myself use an intubating stylet for almost all my intubations except for peds. And I always have a Bougie on the table next to me. If you don’t secure an airway the first time, then you better have a back up ready to go NOW. No matter how good of a tube jockey you might think you are, there is an airway that is out there that will humble you real quick. Confidence is good, over confidence is a killer.
Having been humbled more times than I can count. Roger Coleman CRNA
