It's Better with a Bougie!

A large randomized trial finds higher first-attempt success rates when a bougie is used for endotracheal intubation.

The bougie is traditionally reserved for anticipated difficult airways or for rescue after a failed attempt. Now investigators report on a large trial in which 757 adult patients were randomized to intubation with a bougie or with an endotracheal tube plus stylet. The main outcome was first-attempt success among patients with at least one difficult airway characteristic, and the secondary outcome was first-attempt success for all comers.

All comers to a single emergency department who were undergoing planned intubation with a Mac style blade were eligible. (Because the hyperangulated GlideScope makes bougie passage difficult, patients intubated with this device were excluded.) Ninety-six percent of patients were intubated with the CMAC video…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

It's Better with a Bougie!

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Reviewing Author