title: Endotracheal tube introducer for failed intubations: a variant of the gum elastic bougie.
abstract: There is no universally accepted nonsurgical adjunct for management of the difficult airway in the emergency department. The gum elastic bougie is widely accepted in the British anesthesia literature. One model of endotracheal tube introducer, the Flex-Guide ET Tube Introducer (GreenField Medical Sourcing, Inc, Northborough, MA), is a less expensive plastic version of the gum elastic bougie with the same properties, available in the United States. We present 3 cases of its use in obtaining airway control in difficult airways in the ED. The bougie facilitates intubation where the cords are not visualized or neck movement is contraindicated, allows verification of correct placement before placing the endotracheal tube, is simple to use, and inexpensive to obtain. Reports of 100% first-attempt intubation success in difficult airways are published in the anesthesia literature. We advocate use of this device in the emergency department as a nonsurgical adjunct for difficult airway management.
authors.affiliation: Department of Emergency Medicine, Erie County Medical Center, State University of New York at Buffalo, Buffalo, NY 14215, USA. moscati@ acsu.buffalo.edu
authors.forename: R
authors.initials: R
authors.lastname: Moscati
authors.forename: D
authors.initials: D
authors.lastname: Jehle
authors.forename: G
authors.initials: G
authors.lastname: Christiansen
authors.forename: T
authors.initials: T
authors.lastname: D'Aprix
authors.forename: J
authors.initials: J
authors.lastname: Radford
authors.forename: C
authors.initials: C
authors.lastname: Connery
authors.forename: A
authors.initials: A
authors.lastname: Billittier
mesh_terms: D000328:Adult; D000368:Aged; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D004867:Equipment Design; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010969:Plastics
chemical_list: D010969:Plastics