Bougie Intubations

[iMac]

Interesting question. I have seen more successful in hospital intubations done with bougies than inter/pre-hospital ones. I wonder tho if most of it is what you get used to. Learn to rely on it to much when you have a kit that does not give you accessibility to one. I've only seen 1 tube successfully placed with the use of a boogie.

I don't know that really make a big difference in success rate. If you're used to using one, chances are you will make it easier on yourself if you continue to use it just be careful the day you end up in someone else's truck and there isn't one available. On the flip side, as I posted above most paramedics I know never use one during their intubations and tho the complicated airway shows up from time to time, they never use one.

[Camulos]

Grade 3 or 4 airway

McCoy blade used

Some obese grade 2's

Suspected C-spine injury

Equals Mr bougie

Have also used it once successfully on a pt with a very stiff larynx who was undergoing radiotherapy

Stay safe,

Curse :evil:

[Off Label]

 

Yes, Spen. As AZCEP noted above, I anticipate a difficult airway on any prehospital tube I place. I don't know if it will present as a difficult airway until I look (I may suspect one way or another but have been surprised either way much too often).

 

So, when I go to place a tube, I will have the bougie ready with a tube loaded. During visualization, if it turns out I didn't need it then oh well. It just means I have good practice for all those times when I *DO* need it. But if it turns out I do need it, then I don't have to withdraw the laryngoscope, grab the bougie, load the tube and try again all of which delays getting that patient's airway secure and can cause extra trauma to the patient's airway.

 

-be safe

If more folks took this approach, maybe the field intubation debate wouldn't have occurred.

[1EMT-P]

When faced with a difficult airway there are a number of devices that can be used to improve your odds of securing the airway. If you are interested in learning some good airway techniques I would encourage everyone to check out the procedures section of http://emcrit.org/.

[kohlerrf]

The bougie is the most elegant way to intubate. once you have mastered this brilliantly simple device you will never go back and you can get rid of your secondary airways because you will get the tube every  time!

Bougie dont leave home without it!

[Spock]

The bougie certainly has its place in your airway management tool box along with as many other tools has you can muster.  Just yesterday, I had to use a bougie to place a tube even though I was using a McGrath video laryngoscope for a patient with a know difficult airway.  You have to improvise, adapt, and over come.

May the tube be with you.

Spock