{"id":54514,"date":"2024-03-25T16:54:06","date_gmt":"2024-03-25T15:54:06","guid":{"rendered":"https:\/\/campusvygon.com\/global\/?p=54514"},"modified":"2026-05-19T16:05:42","modified_gmt":"2026-05-19T14:05:42","slug":"the-role-of-bougies-in-ensuring-safe-intubation-during-the-covid-19-era","status":"publish","type":"post","link":"https:\/\/campusvygon.com\/global\/the-role-of-bougies-in-ensuring-safe-intubation-during-the-covid-19-era\/","title":{"rendered":"The Role of Bougies in Ensuring Safe Intubation During the COVID\u201119 Era"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">We are currently living through a pandemic caused by exposure to COVID-19. This infectious disease is caused by the SARS\u2011CoV\u20112 virus, which primarily attacks the respiratory tract, leading to severe pulmonary illnesses.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Since the beginning of the pandemic, invasive therapy has been widely discussed. Recommended for a large number of patients, it aims to treat the effects of the disease on the body through&nbsp;: oxygenation using ventilators, tubes, oxygen, and masks.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">However, accessing the airways in order to apply these invasive treatments represents one of the main risks of contamination for healthcare professionals. This is why all international recommendations and COVID\u201119\u2013specific guidelines emphasize the need to use devices that facilitate access to the airway. They also make it possible to perform rapid intubation. These devices are bougies and tube exchangers.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These tools are designed to manage difficult airways. Without them, most intubations and the maintenance of endotracheal tubes in hospitals would be impossible. However, their role becomes even more critical in this pandemic context.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">THE DIFFERENCE BETWEEN A BOUGIE AND A TUBE EXCHANGER<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Bougies are flexible plastic devices that are slightly deformable, cylindrical, hollow or solid, with or without an internal stylet. Thanks to their 45\u2011degree curved tip, they facilitate access to difficult-to-intubate airways. They can also act as tube exchangers, as they allow patient oxygenation.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"139\" src=\"https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/bougie.jpg\" alt=\"bougie de boussignac\" class=\"wp-image-47638\" style=\"width:823px;height:auto\" srcset=\"https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/bougie.jpg 1024w, https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/bougie-980x133.jpg 980w, https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/bougie-480x65.jpg 480w\" sizes=\"(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) 1024px, 100vw\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">The exchange tube, on the other hand, is a long, straight, hollow cylindrical device, with or without a mandrel, used to administer oxygen to the patient. It facilitates the exchange of endotracheal tubes. Unlike a bougie, it cannot be used to intubate the patient because it does not have a 45-degree curved tip.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>The role of bougies in ensuring safe intubation during the COVID-19 era<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Thanks to their range of sizes, bougies are among on of the most useful devices during this pandemic, enabling successful intubation in all types of patients. In addition, they are perfectly suited to all types of clinical settings, such as:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Operating rooms<\/li>\n\n\n\n<li>Intensive care units<\/li>\n\n\n\n<li>Resuscitation units<\/li>\n\n\n\n<li>Hospital wards<\/li>\n\n\n\n<li>Emergency departments<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">In each of these situations, a bougie is essential whenever difficulty in accessing the airway arises. Relevant authorities recommend their use:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cPlan for the use of an intubation guide.\u201d <mark class=\"has-inline-color has-black-color\"><strong><em><em>Protocol for the clinical management of patients with a novel coronavirus disease (COVID\u201119)<\/em><\/em><\/strong><\/mark>\u201d<em>, issued by the Ministry of Health.<\/em><\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"80\" src=\"https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/640px-Logotipo_del_Ministerio_de_Sanidad_Consumo_y_Bienestar_Social.svg_-300x80-1.png\" alt=\"logo du minist\u00e8re de la sant\u00e9 espagnol\" class=\"wp-image-48307\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cWhen faced with a difficult airway, a video laryngoscope should be used as the intubation device, preferably with a hyper\u2011angulated blade. The use of an intubation guide should also be considered.\u201d <strong><em><mark style=\"color:#7ba180\" class=\"has-inline-color\"><em>Recommendations of the Spanish Society of Anaesthesiology, Critical Care and Pain Management for airway management in patients infected with coronavirus.<\/em><\/mark><\/em><\/strong> <\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"92\" src=\"https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/sedarLogo-052f8a8f-300x92-1.png\" alt=\"logo de la Soci\u00e9t\u00e9 espagnole d'anesth\u00e9siologie, de r\u00e9animation et de traitement de la douleur\" class=\"wp-image-48309\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"735\" height=\"562\" src=\"https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/recommendations-for-airway-management-ENG.jpg\" alt=\"\" class=\"wp-image-54762\" srcset=\"https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/recommendations-for-airway-management-ENG.jpg 735w, https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/recommendations-for-airway-management-ENG-480x367.jpg 480w\" sizes=\"(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) 735px, 100vw\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">INTUBATION GUIDES DURING CARDIOPULMONARY RESUSCITATION IN THE CONTEXT OF COVID\u201119<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The role of these devices in emergency departments is particularly significant. Emergency teams are sometimes overlooked. There may be a perception that COVID\u201119 is only present in hospital emergency rooms and intensive care units. However, early treatment of this disease outside the hospital setting is essential in order to limit the effects of the virus.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Furthermore, in the case of a patient in cardio\u2011respiratory arrest during the COVID\u201119 period, the value of intubation guides for emergency teams is fundamental. <strong><mark style=\"color:#7ba180\" class=\"has-inline-color\">Dr Jos\u00e9 Ignacio Garrote and Dr Boussignac developed protocols for performing cardiopulmonary resuscitation during the COVID\u201119 pandemic.<\/mark><\/strong> <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In addition, many recommendations issued by scientific societies even state that bougies should be considered the first\u2011line intubation option during cardiopulmonary resuscitation when COVID\u201119 is suspected. This recommendation also applies when the patient is confirmed to be COVID\u201119 positive. Only in this way can rapid, efficient, and effective intubation be ensured, while minimizing contact between the healthcare professional and the patient\u2019s airway.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Recommendations on CPR in the context of COVID-19 <\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Let us now review the <strong><mark style=\"color:#7ba180\" class=\"has-inline-color\">modifications made to CPR guidelines during the COVID\u201119 pandemic<\/mark><\/strong> that affect airway management, in which bougies play a crucial role :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>After healthcare personnel have assessed the rhythm and defibrillated any ventricular arrhythmia, patients in cardiac arrest should be intubated with a cuffed endotracheal tube as soon as possible. The endotracheal tube should be connected to a ventilator with a HEPA filter, if possible. <a href=\"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.120.047463\" target=\"_blank\" rel=\"noreferrer noopener\"><mark style=\"color:#7ba180\" class=\"has-inline-color\">Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19<\/mark><\/a> , published by the <a href=\"https:\/\/www.heart.org\/\" target=\"_blank\" rel=\"noreferrer noopener\"><mark style=\"color:#7ba180\" class=\"has-inline-color\">American Hear Association<\/mark><\/a>.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"180\" src=\"https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/1200px-American_Heart_Association_Logo.svg_-300x180-1.png\" alt=\"logo american heart association\" class=\"wp-image-48313\" style=\"width:198px;height:auto\" \/><\/figure>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Airway management should be performed by the most experienced provider. Orotracheal intubation should be carried out as soon as possible using a video laryngoscope with a separate monitor (to allow the greatest possible distance from the patient). The use of a smaller endotracheal tube mounted on an intubation guide (\u201cFrova\u201d) is recommended. These two measures significantly increase the success rate of first\u2011attempt intubation. If the first attempt fails, a supraglottic airway device (SAD) should be inserted. A filter should then be placed directly on the endotracheal tube or the SAD to protect against infection. <em><strong><mark style=\"color:#7ba180\" class=\"has-inline-color\"><em>Recommendations for cardiac arrest management during the COVID\u201119 pandemic from the Catalan Resuscitation Council.<\/em><\/mark><\/strong><\/em> <\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"125\" src=\"https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/ccr-300x125-1.jpg\" alt=\"logo du Conseil Catalan de R\u00e9animation\" class=\"wp-image-48315\" style=\"width:221px;height:auto\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">If you wish to learn more about protocols, new recommendations, and perspectives on cardiopulmonary resuscitation in the era of COVID\u201119, you can consult the interview with Dr Jos\u00e9 Ignacio Garrote, emergency physician at SESCAM, available here.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">THE IMPORTANCE OF COMPLYING WITH REGULATIONS ON SINGLE\u2011USE MEDICAL DEVICES<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">We previously discussed the <mark style=\"color:#7ba180\" class=\"has-inline-color\"><strong>new European regulation governing the reprocessing of single\u2011use medical devices, Regulation (EU) 2017\/745 of the European Parliament and of the Council of 5 April 2017 <\/strong><\/mark>on medical devices. The objective of this regulation was to prevent the <strong><mark style=\"color:#7ba180\" class=\"has-inline-color\">risks posed to patients by the reprocessing of certain products.<\/mark><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"610\" height=\"517\" src=\"https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/regulation-2017.jpg\" alt=\"\" class=\"wp-image-54763\" srcset=\"https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/regulation-2017.jpg 610w, https:\/\/campusvygon.com\/global\/wp-content\/uploads\/sites\/10\/2024\/03\/regulation-2017-480x407.jpg 480w\" sizes=\"(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) 610px, 100vw\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Today, in the context of the global pandemic, many will better understand why the European Union decided to be so strict on this matter. Indeed, numerous guidelines and recommendations from health authorities refer to the use of disposable products whenever possible and, when this is not feasible, to the strict application of all specific cleaning and sterilization protocols.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>We are currently living through a pandemic caused by exposure to COVID-19. This infectious disease is caused by the SARS\u2011CoV\u20112 virus, which primarily attacks the respiratory tract, leading to severe pulmonary illnesses. Since the beginning of the pandemic, invasive therapy has been widely discussed. Recommended for a large number of patients, it aims to treat [&hellip;]<\/p>\n","protected":false},"author":141,"featured_media":48359,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[919,1111],"tags":[],"class_list":["post-54514","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-anaesthesia-and-intensive-care","category-emergencies"],"acf":[],"_links":{"self":[{"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/posts\/54514","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/users\/141"}],"replies":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/comments?post=54514"}],"version-history":[{"count":3,"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/posts\/54514\/revisions"}],"predecessor-version":[{"id":54764,"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/posts\/54514\/revisions\/54764"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/media\/48359"}],"wp:attachment":[{"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/media?parent=54514"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/categories?post=54514"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/campusvygon.com\/global\/wp-json\/wp\/v2\/tags?post=54514"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}