What is a bougie in intubation?

A bougie is a thin plastic rod that is passed into the trachea, over which the endotracheal tube is inserted. Historically, most emergency tracheal intubations in the US have been performed using a stylet, with use of a bougie reserved for difficult intubations.

Why is a bougie called a bougie?

The bougie was first used by Robert Macintosh in 1943 when he encountered difficulty visualizing the vocal cords during ET intubation. The term bougie originally described any flexible, slender, dilator-type device that was inserted into any body orifice for examination or dilation.

How do you exchange an endotracheal tube?

V. Technique: Procedure

1. Procedural Sedation.
2. Place larygoscope and visualize Endotracheal Tube through Vocal Cords.
3. Assistant gently inserts Elastic Bougie through Endotracheal Tube.
4. Remove the Endotracheal Tube after deflating its cuff.
5. Advance new Endotracheal Tube over bougie.

How do you hold a Bougie?

Bougie-assisted Endotracheal Intubation

1. the bougie is typically held by the intubator 20- 30 cm proximal to the coude tip.
2. the bougie should be inserted via the side of the mouth, rather then down the center, so that rotation of the bougie provides better control of the coude tip in the vertical plane.

How does a bougie work?

Bougies are long, stiff plastic wands inserted into the trachea through the glottis during direct laryngoscopy (DL), providing a “guidewire” over which an endotracheal (ET) tube can then be more easily advanced into the trachea.

How often should ET tube be changed?

A patient with an oral endotracheal tube may have an oral airway or bite block in place that should be changed at least every 24 hours. A ventilator, T-tube, or trach collar will provide constant humidification. Corrugated tubing should be emptied by disconnecting the tubing and draining into an appropriate receptacle.

When do you use Bougie?

Bougies have traditionally been used after one or more failed intubation attempts with direct laryngoscopy, at which point the airway is declared “difficult.” The problem: after more than two attempts at endotracheal intubation, the rate of complications skyrockets.

Do you lubricate a Bougie?

Lubricate the distal end and cuff of the endotracheal tube (ETT) with a water-based lubricant and the distal 1/2 of the Bougie device. (Note: Failure to lubricate the Bougie and the ETT may result in being unable to pass the ETT).