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We travelled the known AEU (airway education universe) to seek out the best curated FOAMed, evidence based and practice changing literature, and expert insights on this topic and placed them all here.
Until recently, the bougie was relegated to a drawer in the difficult airway cart, and only used for the occasional emergency. But our understanding and use of tube introducers has evolved. Now we recognize that they can improve first pass success, and help infrequent intubators develop an effective go to strategy in addition to their role in the difficult airway.
These devices are also evolving to meet the times by integrating more effectively into environments where video laryngoscopy predominates. In VL it’s usually not the view that’s the problem, but tube delivery. Tube introducers are finding a new and expanded role not just as devices that can help you initially navigate past the glottic opening but as devices that can help deliver the tube.Jonathan St George MD
A great review of the Driver Study for some potentially practice changing evidence.
Clinical Take Home Point: Although, the results of this trial still need to be validated in other ED settings, use of bougie first instead of as a rescue device when using a standard geometry blade should be strongly considered.