One new airway toy at EMS Today was not a laryngoscope at
all. It’s a new bougie from SunMed. This new malleable introducer is a big
improvement on what is a great second-line airway technique. The original
introducer or bougie was also often called a gum elastic bougie. These simple
“sticks”, are just more than twice the length of an ET tube. You can put them
in first when passing a tube proves initially difficult, and then just slide
the tube in over the top of them. It’s a really great technique for those tough
intubations when you can see the epiglottis but can’t get a decent angle for
passing the tube under it.
I’ve found trying to put the tube on while you hold the
bougie in place a sort of three-handed thing. So I like to pre-load the tube
onto the bougie with enough sticking out to provide that narrow yet firm
advantage. The new SunMed Malleable Introducer or bougie, is the first one of
it’s kind built to use exactly that way. It provides firm directional control
with a stopper to hold the tube in place, right where it should be.
You first pre-load your ET tube onto the
introducer where it stays firmly secured by the movable tube stop. Leave about
3 or 4 inches of bougie protruding out the end of your ET tube, and then form
it to your preferred shape. Once you get the end of the introducer bounced up
under the epiglottis, you slide your tube into the trachea using the introducer
as a guide wire. This cool airway trick is so inexpensive, that everybody should
have one in his or her kit.
Training Video from Airway911