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Evolution of the Tube Introducer

nextgen learning designed to elevate your airway practice


The origins of the bougie and beyond

This learning space on tube introducers covers all the critical concepts, skills and gestures you need to deploy these tools in an emergency, along with a little bit of context and history. Our experts will discuss how and when to use them in real-world care, and teach you the tricks of the trade they rely on in their practice. When you’re done, you’ll be able to take your new skills confidently to the bedside.

Instructions for Use

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Map Your own Journey

New to PAC? We design education that merges digital and physical space for better learning. Listen here, then scroll down to learn how to move seamlessly between them to create your path to mastery.

The Digital Learning Space

Enhanced Digital Content

Use this learning space in two ways. As an online course, scroll down and enter the online learning space. Explore each section below, or use the navigation tool to go directly to the content you’re interested in. Then, use this enhanced digital content in one of our pop-up physical spaces for hands-on procedure training, skills challenges, and expert coaching.

a lesson in design

To stay relevant means changing with the times. How have these devices evolved?

some things never go out of style

So why do you even need to use tube introducers? What is the point if we have video laryngoscopes and endotracheal tubes with stylets? Aren’t these devices a thing of the past? Not so fast….

classic bougie style

Classic bougie style begins with this technique.

the preloaded technique

An efficient single operator technique. It also helps to keep that bougie from falling onto the floor right when you need it!

NExtGen Style Now

Learn how the next generation of tube introducers are changing the game in the age of VL with enhanced design.

integrated design

New devices that make a bougie part of its DNA.

The Physical Learning Space

Procedures, Skills, Coaching

integrated digital & Physical space

This online learning space has enhanced content designed to be part of an immersive, hands-on training lab. The interactive graphic posters create pop-up learning in the physical space for procedure training, skills challenges, expert coaching, simulations, and team training opportunities.

HANDS-ON training

Remember, if you’re in one of our pop-up learning spaces or a PAC Live event, find this icon and use the multimedia tools for hands-on guided practice.

  1. Look for this icon.
  2. Snap the QR code.
  3. Begin your hands-on practice.
  4. Get feedback on your skills.

Don’t forget to ask our faculty coaches for real-time expert feedback and earn points!

User Guide

Open this to help guide you through the space and earn credit toward completion.

  1. Open the guide to a tab on your browser.
  2. Visit each poster & review the content.
  3. Complete any challenges to earn points.

What’s Next


Congratulations! You’ve completed this section of the learning space. Collect all the available points before moving on to the next poster to explore all the interactive and hands-on learning opportunities. 

Online Only

If you can’t be with us in person, you can still use this enhanced digital content as an online course. Visit the digital home page of this learning space by using the link below. Otherwise, head to the next poster above to continue through the physical learning space.

meet the creators

Each learning space takes a collaborative and design forward approach. We draw on the power of the creative arts to inspire and tell stories, on the sciences to improve our clinical practice, and on the diverse perspectives of our combined experience to deepen our knowledge. Each unique creation has one goal: to elevate your emergency airway practice.

Rohan Panchamia MD – Director the Anatomically difficult airway program @PAC

Dr. Rohan Panchamia is a board-certified Anesthesiologist specializing in critical care medicine and transplant anesthesiology. His clinical interests include critical care ultrasound, liver anesthesia, trauma anesthesia, advanced airway education, and resuscitative transesophageal echocardiography.  

Sean Runnels MD – Creator through the cords tube introducers

Dr. Runnels is the founder, inventor, and driving force behind Through The Cords. He is an Associate Professor of Anesthesiology at the University of Utah. He was fellowship trained as a cardiothoracic anesthesiologist at Cambridge University in the UK and has extensive experience in difficult airway management in both high resource and low resource settings. 

JOnathan St George MD – Creator of the protected airway collaborative

Emergency physician and educator. Guided in my belief that high quality airway the guardrail that protects our patients from harm. Full bio here.

PAC posters used in the course are available so you can build these essential emergency airway installations at your shop. Just download and print our interactive posters, and you will have access to all the embedded digital airway content that will walk learners through all the core concepts and skills for this topic. Set them up in any pop up space for learners. Keep them up as long as you like, use them over and over! Just add your own equipment for hands on learning.

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