EMERGENCY CASEBOOK
Out of hospital difficult intubation resolved with nasotracheal use of a gum elastic bougie
1 Prehospital Emergency Department (AP-HP), Hôpital Henri Mondor, Créteil, France
2 Department of Anaesthesia and Intensive Care, Hôpital Henri Mondor, Créteil, France
Correspondence to:
Correspondence to:
Dr X Combes
Service D’anesthésie Réanimation, Hôpital Henri-Mondor, 51 avenue du Maréchal de Lattre-de-Tassigny, 94100 Créteil cedex, France; xavier.combes{at}hmn.ap-hop-paris.fr
We report the case of a 30 year old man managed in an out of hospital setting for a cardiorespiratory arrest. The patient was impossible to intubate under direct laryngoscopy because of a severe mouth opening limitation associated with a buffalo neck. After failure of direct laryngoscopy and intubating laryngeal mask airway, an Eschmann tracheal tube introducer (gum elastic bougie) was introduced through a nostril. The bougie could be blindly inserted into the trachea, and the patient was intubated using the bougie as a guide. Tracheal intubation was then confirmed using the syringe aspiration test and end tidal carbon dioxide detection.
Abbreviations: GEB, gum elastic bougie; ILMA, intubating laryngeal mask airway (ILMA)
Keywords: out of hospital; cardiopulmonary resuscitation; airway management; difficult intubation
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