Figure 42-28 Retrograde intubation with the Cook Retrograde Intubation Set. A, After placement of an 18-gauge sheath needle into the larynx, the J end of the guidewire is inserted in a cephalad direction until it exits the mouth or nose. B, An 11.0-French Teflon catheter is threaded down over the guidewire until it contacts the laryngeal access site. The guidewire is removed from above. C, After advancing the Teflon catheter 2 to 3 cm, the endotracheal tube is advanced into the trachea while maintaining constant control of the catheter. (Courtesy of Cook Critical Care, Bloomington, IN.)