Endotracheal Tube Introducer for failed intubations: A variant of the gum elastic bougie

Ronald Moscati, Dietrich Jehle, Gregory Christiansen, Thomas D'Aprix, John Radford, Cristine Connery, Anthony Billittier IV

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


There is no universally accepted nonsurgical adjunct for management of the difficult airway in the emergency department. The gum elastic bougie is widely accepted in the British anesthesia literature. One model of endotracheal tube introducer, the Flex-Guide ET Tube Introducer (GreenField Medical Sourcing, Inc, Northborough, MA), is a less expensive plastic version of the gum elastic bougie with the same properties, available in the United States. We present 3 cases of its use in obtaining airway control in difficult airways in the ED. The bougie facilitates intubation where the cords are not visualized or neck movement is contraindicated, allows verification of correct placement before placing the endotracheal tube, is simple to use, and inexpensive to obtain. Reports of 100% first-attempt intubation success in difficult airways are published in the anesthesia literature. We advocate use of this device in the emergency department as a nonsurgical adjunct for difficult airway management.

Original languageEnglish (US)
Pages (from-to)52-56
Number of pages5
JournalAnnals of Emergency Medicine
Issue number1
StatePublished - 2000
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine


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