RT Book, Section
A1 White, Steven J.
A1 High, Kevin
A1 Stack, Lawrence B.
A1 Levitan, Richard M.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181051730
T1 Bougie-Assisted Intubation
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181051730
RD 2024/04/25
AB The  Eschmann  Stylet,  also  known  as  a  “gum  elastic  bougie”  or  simply  “bougie,”  is  a  60-cm  long,  flexible  introducer  that  is  designed  to  assist  intubation  of  the  anterior  larynx,  especially  those  with  an  “epiglottis-only”  view.  The  tip  of  the  bougie  has  an  anterior  fixed  flexion  with  an  angle  of  40  degrees  to  facilitate  entering  an  anterior  glottic  opening  (see  Fig.  22.43).  Using  a  laryngoscope,  one  obtains  the  best  view  possible  of  the  glottic  opening.  In  the  case  of  limited  glottic  view  (see  Fig.  22.44),  the  bougie  is  inserted  such  that  the  tip  is  introduced  just  under  the  epiglottis  and  probes  for  the  glottic  opening  (see  Fig.  22.45).  The  intubator  should  feel  a  tactile  “pop”  as  the  bougie  enters  the  trachea,  and  he  or  she  may  also  have  a  tactile  sensation  of  “speed  bumps”  as  the  bougie  is  advanced  and  tracks  across  the  tracheal  cartilaginous  rings  (see  Fig.  22.46).  However,  the  more  sensitive  indicator  of  tracheal  bougie  position  is  the  resistance  encountered  as  the  tip  abuts  against  the  carina,  at  approximately  27  to  30  cm.  Should  the  bougie  be  inserted  into  the  esophagus,  no  such  endpoint  is  encountered.