Back-Up Plan

This is a bougie, a thin plastic rod that is used as a back-up maneuver when we have difficulty intubating the trachea. Occasionally, after sedating a patient and paralyzing him, we take a look with a laryngoscope but can't see the vocal cords very well. If we can't get an endotracheal tube into the airway, we can occasionally try slipping this device in as it's thinner and more easily maneuvered. The bent tip allows us to guide it into the trachea and as it passes down, it clicks as it goes over the cartilage rings and stops when it hits the first split of the trachea into the right and left bronchi. When I felt this, I was amazed by the sensation. Once it's in, we slide a tube over it, and it acts as a stylet to guide the tube into the right place.

Image of bougie shown under Fair Use, from healthsystem.virginia.edu.