Chapter 15 - Tracheal Tube Introducers (Bougies), Stylets and Airway Exchange Catheters

Summary

Tracheal tube introducers or bougies and airway exchange catheters (AECs) are widely used airway adjuncts for facilitating airway management in difficult circumstances. They are easy to use, relatively inexpensive and have success rates of ≥ 90% in most settings. Both are included in many modern airway management algorithms. The use of bougies has expanded over the years, and they are now used to aid insertion of supraglottic airways (SGAs), videolaryngoscope-guided intubation and as adjuncts to emergency front of neck airway procedures. Stylets are rigid or semi-rigid airway adjuncts that are inserted into the tracheal tube before intubation. They maintain the tracheal tube in a particular shape and may therefore assist during intubation. AECs are semi-rigid hollow tubes designed to aid airway device (SGA, and single- or double-lumen tracheal tube) exchange or to manage ‘at-risk’ extubation. The risk of serious airway trauma associated with the use of bougies and airway exchange catheters, and the risk of barotrauma with the latter, invites cautious and educated use of these devices.