Darren Braude, Aiway and EMS master from New Mexico demonstrates the use of a bougie to make the cric procedure MUCH easier. For more great Braude magic, see his site at airway911.com.
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This Post was by Scott D. Weingart, MD. We never spam; we hate spammers! Spammers probably work for the Joint Commission.
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[...] This post was mentioned on Twitter by sandnsurf and Sam Ko, Sam Ko. Sam Ko said: Using a bougie for emergency cric – http://blog.emcrit.org/procedures/bougie-aided-cric/ @emcrit [...]
[...] Bougie Assisted [...]
Hi, my name is Scott Weingart. 
Hi, I just did my first cricothyrotomy and I REALLY want to thank you Dr Weingart for posting this video, and I also want to thank Dr Braude for his MUST READ book “Rapid Sequence Intubation and Rapid Sequence Airway: An Airway 911 Guide” and Dr Billy Melon for the cric hands-on practice session at the last Essentials! To make a long story short, I had to go on the floors this evening to evaluate a patient who had develop an hoarse voice and a progressive stridor over the day (god knows why for now except that he was extubated 7 days earlier?). I decided to try and intubate him sooner than later. I knew this was going to be a tough intubation, with this clinical presentation, so I marked the skin with my Industrial Sharpie pen (thanks again Dr Weingart) as I asked the staff to take the patient downstair where my staff and equipment is better suited for what was to come. We did it RSI and with the Glidescope to give me all the best chances, but as I feared no cords were there to see. I had no other choice but to go with what I had marked with an X on the neck. I did it bougie-aided and thanks to all of you guys… it was a piece of cake!!! It was as if I had done it at least ten times before. You guys do a wonderful job at making emergency physicians better.
hey Scott,
Just wondering given the time critical nature of a surgical cric in a CICV scenario do you think it would be useful and practical to have your boogie preloaded with your size 6 ETT before using it? My thinking would be that the ETT would be pre-loaded but not near the distal end of the bougie so you could still feel the tracheal anatomy with it. Soon as you are comfortable you are in the right place you could then just slide the ETT down it into the airway.
Thoughts?
I like the maneuverability of an unburdened bougie. Not sure how much I gain by the preload. However I don’t see any reason it would not work.
yep agree, the maneuverbility of a preloaded bougie might be an issue with conventional bougie use from mouth to trachea but with the short distances involved in a surgical cric thought would be a non issue and might save some time.