ETT exchange

Q: Endotracheal tube (ETT) introducer, popularly known as a bougie, can be safely used to exchange malfunctioning ETT?

A) True

B) False

Answer: B

Bougie is not designed to exchange malfunctioning ETT. Its main purpose is to facilitate presumed difficult intubations and should be use as an introducer during such intubations. Using a bougie as an ETT exchanger risks the loss of airway as a standard bougie is usually 60 to 70 cm long and barely allows the full length of the ETT to leave the mouth. 

The standard (and proper) ETT exchangers are usually 80 cm long, are designed solely for this purpose, and can be use without risking the loss of airway.

#procedures

Further read:

1. Heidegger T, Oberle F. Endotracheal Tube Exchange. N Engl J Med. 2023 Mar 16;388(11):e34. doi: 10.1056/NEJMvcm2020253. PMID: 36920758.

2. Hartmannsgruber MW, Rosenbaum SH. Safer endotracheal tube exchange technique. Anesthesiology. 1998 Jun;88(6):1683. doi: 10.1097/00000542-199806000-00038. PMID: 9637668.