Using a Disposable Flexible Fiberoptic Scope as a Bougie for Difficult Intubation
In this case report, we describe two difficult intubations in which an endotracheal tube was threaded over a fiberoptic bronchoscope that was acting as a bougie. Our patients initially presented with limited neck extension, narrow mouth opening, and restricted view of the glottic region. A fiberopti...
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Published in: | Journal of emergencies, trauma and shock Vol. 17; no. 1; pp. 43 - 45 |
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01-01-2024
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Abstract | In this case report, we describe two difficult intubations in which an endotracheal tube was threaded over a fiberoptic bronchoscope that was acting as a bougie. Our patients initially presented with limited neck extension, narrow mouth opening, and restricted view of the glottic region. A fiberoptic bronchoscope was guided through while the patient was oxygenated through a laryngeal mask. After the scope provided an unrestricted view of the vocal cords, the digital module was removed by cutting the fiberoptic thread, and an endotracheal tube was passed through. After proper confirmation of the endotracheal tube position, the intubation was deemed successful and thereby, we share our experience with the novel technique. This technique may potentially improve critical patient outcomes whether in trauma or an unexpectedly difficult intubation. |
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AbstractList | In this case report, we describe two difficult intubations in which an endotracheal tube was threaded over a fiberoptic bronchoscope that was acting as a bougie. Our patients initially presented with limited neck extension, narrow mouth opening, and restricted view of the glottic region. A fiberoptic bronchoscope was guided through while the patient was oxygenated through a laryngeal mask. After the scope provided an unrestricted view of the vocal cords, the digital module was removed by cutting the fiberoptic thread, and an endotracheal tube was passed through. After proper confirmation of the endotracheal tube position, the intubation was deemed successful and thereby, we share our experience with the novel technique. This technique may potentially improve critical patient outcomes whether in trauma or an unexpectedly difficult intubation. |
Audience | Academic |
Author | Shawaqfeh, Nedal Rabadi, Daher K Madain, Zaid Abubaker, Ahmad K Almasarweh, Sami A Alsalman, Salem R |
AuthorAffiliation | 2 Department of Intensive Critical Care, Jordanian Royal Medical Services, Amman, Jordan Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan 1 Jordan University Hospital, University of Jordan, Amman, Jordan |
AuthorAffiliation_xml | – name: Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan – name: 2 Department of Intensive Critical Care, Jordanian Royal Medical Services, Amman, Jordan – name: 1 Jordan University Hospital, University of Jordan, Amman, Jordan |
Author_xml | – sequence: 1 givenname: Daher K surname: Rabadi fullname: Rabadi, Daher K organization: Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan – sequence: 2 givenname: Sami A surname: Almasarweh fullname: Almasarweh, Sami A organization: Jordan University Hospital, University of Jordan, Amman, Jordan – sequence: 3 givenname: Ahmad K surname: Abubaker fullname: Abubaker, Ahmad K organization: Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan – sequence: 4 givenname: Nedal surname: Shawaqfeh fullname: Shawaqfeh, Nedal organization: Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan – sequence: 5 givenname: Salem R surname: Alsalman fullname: Alsalman, Salem R organization: Department of Intensive Critical Care, Jordanian Royal Medical Services, Amman, Jordan – sequence: 6 givenname: Zaid surname: Madain fullname: Madain, Zaid organization: Jordan University Hospital, University of Jordan, Amman, Jordan |
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Cites_doi | 10.1016/S0736-4679(02)00501-2 10.1007/BF03027728 10.1111/j.1365-2044.2007.05152.x 10.1016/j.annemergmed.2007.05.022 10.1007/BF03012147 10.1016/j.jemermed.2014.04.021 10.1213/ANE.0000000000004102 10.1111/j.1365-2044.2010.06513.x 10.1111/anae.13042 10.5847/wjem.j.1920-8642.2019.04.003 |
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Keywords | Critical care endotracheal intubation laryngoscopes rapid sequence induction and intubation |
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References | Fitzgerald (R4-20240828) 2015; 70 Mitra (R8-20240828) 2019; 10 Crosby (R6-20240828) 1998; 45 Cooper (R2-20240828) 2005; 52 Teoh (R3-20240828) 2010; 65 Koyama (R5-20240828) 2007; 62 Kovacs (R7-20240828) 2007; 50 Bair (R9-20240828) 2002; 23 Mazzinari (R1-20240828) 2019; 128 Gaither (R10-20240828) 2014; 47 |
References_xml | – volume: 23 start-page: 131 year: 2002 ident: R9-20240828 article-title: The failed intubation attempt in the emergency department: Analysis of prevalence, rescue techniques, and personnel publication-title: J Emerg Med doi: 10.1016/S0736-4679(02)00501-2 contributor: fullname: Bair – volume: 52 start-page: 191 year: 2005 ident: R2-20240828 article-title: Early clinical experience with a new videolaryngoscope (GlideScope) in 728 patients publication-title: Can J Anaesth doi: 10.1007/BF03027728 contributor: fullname: Cooper – volume: 62 start-page: 936 year: 2007 ident: R5-20240828 article-title: Comparison of the airway scope, gum elastic bougie and fibreoptic bronchoscope in simulated difficult tracheal intubation: A manikin study publication-title: Anaesthesia doi: 10.1111/j.1365-2044.2007.05152.x contributor: fullname: Koyama – volume: 50 start-page: 676 year: 2007 ident: R7-20240828 article-title: A comparison of a fiberoptic stylet and a bougie as adjuncts to direct laryngoscopy in a manikin-simulated difficult airway publication-title: Ann Emerg Med doi: 10.1016/j.annemergmed.2007.05.022 contributor: fullname: Kovacs – volume: 45 start-page: 757 year: 1998 ident: R6-20240828 article-title: The unanticipated difficult airway with recommendations for management publication-title: Can J Anaesth doi: 10.1007/BF03012147 contributor: fullname: Crosby – volume: 47 start-page: 294 year: 2014 ident: R10-20240828 article-title: Prevalence of difficult airway predictors in cases of failed prehospital endotracheal intubation publication-title: J Emerg Med doi: 10.1016/j.jemermed.2014.04.021 contributor: fullname: Gaither – volume: 128 start-page: 1264 year: 2019 ident: R1-20240828 article-title: Effect of dynamic versus stylet-guided intubation on first-attempt success in difficult airways undergoing glidescope laryngoscopy: A randomized controlled trial publication-title: Anesth Analg doi: 10.1213/ANE.0000000000004102 contributor: fullname: Mazzinari – volume: 65 start-page: 1126 year: 2010 ident: R3-20240828 article-title: Comparison of three videolaryngoscopes: Pentax airway scope, C-MAC, glidescope versus the Macintosh Laryngoscope for tracheal intubation publication-title: Anaesthesia doi: 10.1111/j.1365-2044.2010.06513.x contributor: fullname: Teoh – volume: 70 start-page: 387 year: 2015 ident: R4-20240828 article-title: ‘From darkness into light’: Time to make awake intubation with videolaryngoscopy the primary technique for an anticipated difficult airway? publication-title: Anaesthesia doi: 10.1111/anae.13042 contributor: fullname: Fitzgerald – volume: 10 start-page: 210 year: 2019 ident: R8-20240828 article-title: Confirmation of endotracheal tube placement using disposable fiberoptic bronchoscopy in the emergent setting publication-title: World J Emerg Med doi: 10.5847/wjem.j.1920-8642.2019.04.003 contributor: fullname: Mitra |
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SubjectTerms | Airway management Case Report Case reports Critical care endotracheal intubation Equipment and supplies Fiber optics Intubation laryngoscopes Laryngoscopy rapid sequence induction and intubation |
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Title | Using a Disposable Flexible Fiberoptic Scope as a Bougie for Difficult Intubation |
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