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Old 07-13-2008, 22:26   #7
Doc Dutch
Trauma Surgeon
 
Join Date: Sep 2007
Posts: 83
RF,

I do think next time (because there is always a next time or so it seems) I will go with the 16 or 14 gauge if I can find it readily. Bigger would have been better as it probably affords less kinking. I also agree with you that pointing the angiocatheter caudal and sliding the needle out once the angiocath is in or pushing in the catheter and removing the needle. I am not sure as to why for the first few attempts I could not pass the catheter over the needle and into the trachea. That was frustrating.

The retrograde intubation is a great idea. I have actually used this in another pediatric case (10 year old with c-spine and a t-spine fractures in a halo that lost his airway). The anesthesiologist and I did it together. Now that was "un-fun", but is really good to have in your arsenal of airway tools.

D-
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