What is a bougie, and when is it particularly useful during endotracheal intubation?

• A. A rigid introducer used to guide the endotracheal tube.
• B. A flexible introducer used to guide the tube, useful when glottic view is suboptimal or during difficult intubation.
• C. A laryngoscope blade with camera.
• D. A suction device.

Answer: (B)

A bougie is a flexible, long introducer that acts as a guide for the endotracheal tube. It’s designed to be placed through the glottis and into the trachea when visualization of the vocal cords is limited or the airway is difficult to intubate. The clinician can feel the passage into the trachea (often described as a “hold-up” at the tracheal rings) and then advance the endotracheal tube over the bougie into place. This makes securing the airway more reliable when the view is suboptimal, during difficult airways, or when more maneuverability is needed than a rigid stylet provides. After the tube is in place, the bougie is removed.

It’s different from a rigid introducer, a laryngoscope blade with a camera, or a suction device, which serve other roles in airway management.