Rigid Bronchoscope-Assisted Endotracheal Intubation: Yet Another Use of the Gum Elastic Bougie

Nekhendzy, Vladimir; Simmonds, Paul K.

doi:10.1213/01.ane.0000097184.55842.c2

Cited by 20 publications

(4 citation statements)

References 16 publications

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“…1 ETT introducer is also used for ETT exchange, preferred over AEC by some, as it is believed to be rigid enough to facilitate proper railroading. 2,3 As AEC was not readily available in the OR, ETT introducer (bougie) was used for tube exchange. Any device passed through ETT can exit through Murphy's eye instead of the tip.…”

Section: Discussionmentioning

confidence: 99%

Bougie through Murphy’s Eye During Airway Exchange: A Near Miss

Sameera

Biswas

Rath

2020

J Neuroanaesth Crit Care

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Endotracheal tube (ETT) exchange is a common procedure performed in the operating room and intensive care unit for the purpose of changing damaged or soiled ETT with appropriate one. The exchange procedure is performed over an airway exchange catheter or ETT introducer (bougie). We report an event during ETT exchange over bougie wherein the introducer exited through Murphy’s eye. Here, we intend to re-emphasize the safety concerns pertaining to the use of bougie (with coude tip) as airway exchange conduit and enumerate the precautions to be taken during tube exchange.

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Section: Discussionmentioning

confidence: 99%

Bougie through Murphy’s Eye During Airway Exchange: A Near Miss

Sameera

Biswas

Rath

2020

J Neuroanaesth Crit Care

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“…The CAEC is a long hollow and semirigid catheter with a small inner diameter that is designed for exchanging an ETT with insertion through an in situ ETT prior to tracheal extubation 4. Nekhendzy et al reported a case of using the gum elastic bougie to aid a difficult endotracheal intubation in a patient undergoing rigid bronchoscopy 5…”

Section: Discussionmentioning

confidence: 99%

Revisiting a case of difficult airway with a rigid laryngoscope

Bh¹,

Shariat

2019

BMJ Case Rep

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A cook airway exchange catheter is a long hollow and semirigid catheter which is routinely used for endotracheal tube (ETT) exchange in the intensive care unit setting or even in the operating room in an event of unexpected difficult airway. We describe a novel technique of using an ETT exchanger with the help of a rigid laryngoscope to facilitate intubation as a strategy in a patient with an anticipated difficult airway due to laryngeal cancer presenting as stridor with respiratory distress.

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“…Hillel and colleagues have shown that the use of surgical laryngoscopes helped secure over 35% of difficult airways and reduced the number of emergent cricothyroidotomies to nearly half [34]. After an operative laryngoscope or rigid bronchoscope is placed, manual ventilation can be provided safely through the lumen of the scope and subsequently, endotracheal intubation can be performed with the aid of an airway exchange catheter or a gum elastic bougie [35]. Thus, operative laryngoscopy and rigid bronchoscopy can rescue failed tracheal intubation and cannot intubate/cannot oxygenate (CICO) situations.…”

Section: Surgical Laryngoscopy and Rigid Bronchoscopymentioning

confidence: 99%

Principles of Anesthesia and Airway Management in Head and Neck Surgery

Khan¹,

Tageldin²,

Farooqi³

et al. 2021

Surgical Management of Head and Neck Pathologies

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This topic aims to discuss key aspects of anesthetic and airway management for head and neck surgery. Airway management is a central part of patient care and management in Head and Neck Surgery. Common challenges in Head and Neck surgery are shared airway, distorted airway anatomy due to existing pathology; risk of airway obstruction, disconnection or loss of airway intra-operatively; risk of soiling of the airway due to bleeding and surgical debris; and the potential for airway compromise post-operatively. The option for airway management technique is influenced by patient’s factors, anesthetic needs, and surgical requirements. Intubation technique necessitating either a small or large cuffed tracheal tube with a throat pack provides the highest level of airway protection Non-intubation or open airway techniques involve mask ventilation, apneic techniques, and insufflation techniques, or the use of a laryngeal mask airway. Lastly, jet ventilation techniques may be conducted via a supraglottic, subglottic or transtracheal routes. It is essential to have clear airway management plans including rescue airway strategies that should be communicated with the surgeons and patients at the earliest opportunity.

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Rigid Bronchoscope-Assisted Endotracheal Intubation: Yet Another Use of the Gum Elastic Bougie

Abstract: We describe a technique of using a gum elastic bougie to facilitate an endotracheal intubation in a patient undergoing rigid bronchoscopy, which can be useful in a variety of clinical situations when the rigid bronchoscope is used in patients with abnormal airway.

Cited by 20 publications

References 16 publications

Bougie through Murphy’s Eye During Airway Exchange: A Near Miss

Bougie through Murphy’s Eye During Airway Exchange: A Near Miss

Revisiting a case of difficult airway with a rigid laryngoscope

Principles of Anesthesia and Airway Management in Head and Neck Surgery

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