Contributor: Aaron Lessen, MD

Educational Pearls:

• An endotracheal tube introducer or bougie are often used as a rescue device during difficult intubations as they are small and can be placed blindly
• Large randomized-controlled trial looked at first-pass bougie use versus standard intubation to determine if there was improvement in first-pass success rate
• No difference in first-pass success rate, about 80% for both techniques
• This does not mean that bougies are not great rescue devices or options for managing an airway

References

Driver BE, Semler MW, Self WH, et al. Effect of Use of a Bougie vs Endotracheal Tube With Stylet on Successful Intubation on the First Attempt Among Critically Ill Patients Undergoing Tracheal Intubation: A Randomized Clinical Trial. JAMA. 2021;326(24):2488–2497.

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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