A New Bougie for your Pocket by Jim DuCanto

Jim DuCanto just sent two OR videos with intubations using a new bougie made to keep in your pocket or small kits: the pocket bougie by Bomimed.

In the video above, Jim is using a Glidescope with the new bougie. He also demonstrates his crankshaft maneuver.

In this second video, Jim is using a Mac blade with the bougie in a patient with high BMI (125 kg).

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Comments

  1. Seth Trueger says:

    looks great! how much do they cost?

  2. Minh Le Cong says:

    $25 ea , $17 ea as bulk sale to hospitals

  3. Don Diakow says:

    In the glidescope video the preox device… was that a Non-invasive Cpap / Bi-pap device?
    Cool product and what we need EMS wise as the current Bougie is tough to store due to it’s length.

    • Don,
      I believe that is an oxylator. Google “oxylator” and it will show the website.

      I agree with your comment on EMS and bougie storeage. We store our bougies, curled up in a kit. They never work the same after. I will definitely look into this

    • That was an Oxylator, which Dr. DuCanto uses extensively (from the videos I’ve seen). It is a pressure-limited, flow-triggered ventilation device. He talks about using it in this podcast with Minh.

    • Regular bougies can be bent in half to fit without any problem

    • Brian Gacioch says:

      Hi Don,
      One storage option for keeping the conventional bougie straight is under the upper body half of the mattress on the stretcher. Certainly won’t solve every problem, as you won’t always have your stretcher with you, but it may come in handy from time to time.
      Brian

    • ricko2stat says:

      Don,
      If you are looking for a disposable CPAP that you can control the FIO2. Check out the O2-MAX from Pulmodyne.

  4. Anandan says:

    This looks very flimsy.I think it is very difficult to get it in in difficult airways compared to the conventional bougie. Your thoughts ?

  5. vincent says:

    I first saw this bougie at the Difficult Airway Course in Las Vegas. I thought it was very flimsy but I was holding it incorrectly. The rep showed me the correct way to hold and how the distal tip can be flexed upwards, there has been no going back for us. The tracheal click sensation is incredible. I admit the price was hard to convince admin. But I believe it is worth it….not just a regular bougie.

  6. Jimmy D says:

    This bougie is an unusual incarnation, material-wise and handling wise. Plastic can be good, and plastic can be bad. My department stocks the blue Portex bougies, which are ok, but they will not accept a shape modification like the Pocket Bougie, so they are pretty much worthless to use with the Glidescope.

    Yes, it was an Oxylator EMX. The biggest user of the Oxylator in the USA is the US Government–they are tasked to multiple special forces units. Don’t get me started on the Oxylator, or we will be here all day–simply go to this link to look at my slide show on Slideshare.net:

    http://www.slideshare.net/James_DuCanto_MD/the-oxylatora-compact-and-durable-patient-responsive-ventilation-system

  7. First and foremost, I must disclose that I represent BOMImed, manufacturer of the Pocket Bougie. Secondly, I want to express my gratitude to Dr. DuCanto, whom I consider the Spielberg of video production on the Management of Difficult Airways, for posting his experience with the Pocket Bougie as well as Dr. Weingart for adding Dr. DuCanto’s videos to this very useful site. I thought I would add a quick summary explaining “WHY” we created the Pocket Bougie. we know Bougies save lives. Studies have shown as high as a 90+% first pass success rate when using a Bougie in combination with Direct Laryngoscopy. In fact many services throughout the nation will use a Bougie with either first or second attempts with direct laryngoscopy.
    However, most complaints we’ve heard with Bougies in general are as follows:
    -Difficult to store in tactical/EMS bags
    -must be stored straight
    -lack shape memory
    -too rigid and high risk of airway perforation
    -if they are bent, they are unusable
    -require lubrication
    -cannot be customizable
    -cannot get a “good” feel of tracheal rings
    -in extreme heat, the straight bougies become useless as they become very floppy

    We simply asked ED physicians, Anesthesiologists and Medics how we can make a bougie better.
    What we developed was the Pocket Bougie.
    First and foremost,
    -We designed the Pocket Bougie to fit into an airway bag or cargo pant pocket so it could easily be deployed for an airway rescue
    -We made a curved bougie to follow the natural path of the airway
    -The curved bougie also allows for a one person intubating technique vs two.
    -We use Teflon as our material, so the Pocket Bougie is self lubricated
    -The Teflon material allows for malleability and will maintain its shape once it has been customized by the person intubating
    -The Teflon allows for a more pronounced tactile sensation of the tracheal rings when entering the airway
    -The addition of rounded soft dome tips make the Pocket Bougie safer to use
    -Versatility: The Pocket Bougie can be used not only for Direct and Video Laryngoscopy, but also be used for bougie assisted cricothyrotomy.
    -The Pocket Bougie can be used from either end with customizable coude tip angles
    -The tip of the Pocket Bougie can be flexed anteriorly for the very anterior airway(neck mobilization) using the Trigger Hold Technique especially when you can see the cords, but cannot intubate
    – the Pocket Bougie will maintain its integrity in extreme heat
    Here is a small educational/marketing video on Pocket Bougie:
    http://www.youtube.com/watch?v=9gwP_ab_LlY
    Below are some more videos showing the versatility of the Pocket Bougie for different airway cases:
    Pocket Bougie for Trach Tube Change
    http://www.youtube.com/watch?v=otsIzCpXIIg

    Pocket Bougie, DL with Preload and Flexing of distal tip for Anterior Airway
    http://www.youtube.com/watch?v=JEi8LQFhfM0

    Pocket Bougie with King Vision
    http://www.youtube.com/watch?v=X9D1TOc9v_Q

    Pocket Bougie with Glidescope
    http://www.youtube.com/watch?v=5Wb1_WETWdo

    Pocket Bougie, One Person Technique with Trigger Hold
    http://www.youtube.com/watch?v=WDnDjfuh1Dc

    Pocket Bougie with Karl Storz Video Laryngoscope
    http://www.youtube.com/watch?v=bar9xgLbO_Q

    Glidescope with Pocket Bougie
    http://www.youtube.com/watch?v=cKt3g-x96HU

    Pocket Bougie with DL in Obese Patient
    http://www.youtube.com/watch?v=AiNkgKhSHm4

    Please feel free to contact me directly if you have any questions. My email address is fgulamani@bomimed.com.

  8. For those that inquiring about purchasing the Pocket Bougie in Australia, I am currently looking into this and will post shortly.

    For those that use channel devices, here is an interesting video showing the Pocket Bougie used with the Airtraq Avant

  9. Below is a new video demonstrating the hold technique aswell as how to flex the distal tip of the Pocket Bougie:

  10. Any update on pocket bougie down under?

  11. Scott, do you believe the pocket bougie (particularly while using the glidescope) is superior to regular bougie +trigger/shaka technique?

    • For hyperangulated blades (we can no longer call them Glidescope or CMAC as both companies make both blade types) I markedly prefer the pocket bougie. That being said, I kind of hate hyperangulated blades and don’t use them.

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