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Why It’s Good to Be Bougie

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In this space, let’s discuss why it’s okay to be bougie. You may wonder why this “accessory” to intubation is still around, but the evidence suggests expanded possibilities for their use beyond as a rescue device for difficult airways, and there are some good reasons for this.


This space is organized from rapid review to deep dive to bring you the most essential knowledge first. You can also customize your learning by exploring what’s important to you by using the navigation tool below.

Audio IntroRapid ReviewExpanded Use
Full VideoEvidence ReviewFOAMed
Source MaterialNext StepsTo Evolution TI
Rapid Review

Get some high speed hits of essential knowledge and prime yourself for what comes next. ⏩

what’s the difference?

What is the reason tube introducers continue to evolve and expand their role in airway management? It’s because they’re designed with a single purpose: tracheal access, and subsequently, enhanced tube delivery. Let’s quickly compare some of the common design features of tube introducers vs the design features of the modern endotracheal tubes, and then you’ll begin to see their advantage when it comes to intubation success.

Expanding Indications

When most people think of tube introducers they think of the standard blue bougie, and then only as a difficult airway adjunct, but evidence suggests it has an expanding number of roles in clinical practice. Here are just a few.

design with purpose

Many people ask us, do you even need to learn about tube introducers in the age of VL? I thought they were a relic of the DL age? Well, not so fast. Let’s talk about the design features and intention of the bougie to help explain why they remain a valuable part of your airway practice.

Some Evidence

There’s some good evidence that tube introducers like the standard bougie can improve first pass success. Some clinicians, particularly those in emergency settings have seen this potentially game changing evidence, and shifted to a “bougie first” mindset.

Evidence Based Bougie – How do tube introducers stack up when compared to stylets?

clinical pearl

Something to consider as you work on your bougie skills. It can be more than just a backup plan📚

foam resource

@JohnCSakles is one of our favorite FOAMed airway educators. He is in our extended learning network. Take a moment and put him in yours. You’ll be glad you did 📚

Return to the Source

Dive into some the most intriguing and practice changing papers published on this topic. We’ve gone to the source and collected what we think are the ones you should definitely know about.


Sure you could stop here, but why would you? If you’re in the physical learning space: 1. Locate any of the posters below to continue. 2. Look for integrated hands-on training opportunities using guided audio and videos to enhance your practice. 🎧👇3. Visit faculty coaches to get feedback on your technique. If you’re online, head back to the complete digital learning space using the link below.

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