Cite this post as:
Guest Author. EMCrit Guest Post – Bougie Lessons from the Literature and Experience by George Kovacs. EMCrit Blog. Published on January 3, 2020. Accessed on April 26th 2024. Available at [https://emcrit.org/emcrit/bougie-lessons-from-the-literature/ ].
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Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
CME Review
Original Release: January 3, 2020
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
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Also consider that not all bougies are the same. I had used SunMed bougies in residency and fellowship, and based on my experience with them I became a vocal advocate for universal bougie use. Unfortunately my current hospital has switched to Portex bougies, which are too floppy to be useful. I’ve given up on trying to teach the residents to use them.
Just a cautionary note. I use bougie for most of my intubations, no problems so far. However, one of our very sharp EM guys did manage to perforate a bronchus intubating a pt before they came up. Was a conscientious careful boarded EM doc, not a cowboy, who thought he felt a “click”. Moral of the story being there is no such thing as a complication-free procedure, and like one of my old surgery preceptors in residency said- “if you haven’t had a complication, then you probably haven’t done very many.”.
I see the advantages of a bougie but I am still not convinced that a stylet is that much worse.
Stylet needs to be trained and properly prepared.
In a former study by Driver et al (10.1016/j.annemergmed.2017.04.033) FPS without a bougie was 86% in the one cited endotracheal tube + stylet group FPS was 82%.
Do you have explanations for that?
If i remember right, I read that bougie use was well trained and routine for that ED. Would be interesting to see data on FPS of a group that routinely uses stylets.