Flextip ETT introducer (boujie)

[MARK FORREST]

Hi Dave,
If you can get one, grab it and hang on!! This is probably the one piece of additional kit that any UK anaesthetist would request if they had to choose. So much so, that many colleagues use them almost as routine, both in hospital and pre-hospital (HEMS in London, have always encouraged it's use in all pre-hospital intubations). This will help you to intubate grade III and IV intubations where you have 'no view' whatsoever, as it can be advanced over and behind the epigglottis to the larynx that you cannot see.
 
This device really does make life far much easier, especially when the larynx cannot be visualised or even when the cords can be seen but directing the tube is difficcult (eg small mouth, lots of teeth etc). The bougie is far more versatile than the stylet and we also have versions such as the 'Aintree catheter' (COOK) which is hollow and allows insufflation of oxygen from a standard connector. This hollow device also allows passage of a fibreoptic scope through it's core and this is often used when passing it through a laryngeal mask. An ET tube can then be passed over the scope and the catheter and through the LMA into the larynx...easy!! (or you can use it as an exchange catheter, passing it through the LMA, then removing the LMA and using the Aintree Cath as a guide for your ET tube into the larynx.....this technique has virtually replaced awake fibre-optic intubation in many elective difficult intubations and works in the ER as well, as it is almost as easy blind
 without the scope. 
 
Get yourself a bougie and carry it everywhere that you are likely to intubate.....but, beware as there are some terrible, cheap and nasty plastic versions which are hopeless.
 
Cheers
Mark F
Cons Anaes/Crit Care, UK


----- Original Message ----
From: David Sullivan <fpcems at yahoo.com>
To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org>
Sent: Tuesday, 29 August, 2006 1:28:25 PM
Subject: Flextip ETT introducer (boujie)


Hey all, 
   
  I was wondering if there is any in/pre-hospital providers that use the boujie (sp) for suspected difficult intubations? I did some recent training with it, teaching in the paramedic program at Northeastern Univ in MA, Im under the assumption that in MA its only approved for Umass medical center EMS and Boston Medflight. Im thinking about doing a research project to see the use of it as a back up device, when direct visualization is difficult or impossible, or the use of it on a c-spine pt that needs intubation? Any thoughts?
   
  dave sullivan BA NREMT-P

                
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