Skip to content

DuCanto & Chow describe an improvement on the Kiwi & Pistol Bougie grips

Frova Bougie in D Grip configuration

Frova Bougie in D Grip configuration

Frova Bougie released from D Grip

Frova Bougie released from D Grip

Dr James Du Canto ( Wisconsin, USA) and Dr Yen Chow ( Ontario, Canada) have been collaborating via FOAMEd ( Twitter and email and Google +) in the last 2-3 weeks on the concept of modifying the Kiwi and Pistol Grips.

What they have come up with is called the D Grip.

Jim was generous to donate his time to record a quick hangout to further elaborate on the modification. Please excuse some missing sound..I think you will get the idea. Along the way Jim discussed the mechanics behind his Paleo grip modification as well to holding the laryngoscope

Now Yen also recorded a demo video of the D Grip so here it is!

Try it out on a mannikin first. I think you will like it!

Advantages:

  1. Single operator technique
  2. Bougie already preloaded with ETT – faster, smoother
  3. still retain advantage of using bougie tip to intubate trachea
  4. no extra cost
  5. works with VL and DL

Disadvantages:

  1. May damage Murphy eye of ETT
  2. ??

Here is what it looks like on the BomiMed Pocket Bougie

Pocket Bougie D grip configuration

Pocket Bougie D grip configuration

Pocket Bougie released from D Grip

Pocket Bougie released from D Grip

5 Comments Post a comment
  1. Thanks for posting and recording this Minh and Jim. Sorry that I missed out on the chat!

    What I love about this is that you are independent especially if you have limited assistance in PHARM or rural settings. It is also very sleek and fast.

    The d-grip with murphy eye lock on the bougie end allows it to be shaped and kept on a dumpkit/table and easily picked up with the syringe in one hand (think “91” on the setup and the syringe points up like a rocket). You can easily and efficiently pick up the yankauer and suction, replace it, and move to ELM and bougie intubation followed by unlocking the bougie proximal tip from the murphy eye and then railroading and inflating the cuff. All with the one hand, no assistant. Jim also mentioned you can also use your right hand to do other things too during laryngoscopy like apply distracting forces on the right upper eye teeth behind the canines for better laryngeal exposure. This is not something I have done before but will try it in the sim lab. I am also itching to try paleo too.

    Back to d-grips:

    I also worried about damage to the murphy’s eye but it does not seem to cause a problem if one is careful about disengaging it. Locking the ETT/bougie on the laryngoscope-holding-hand’s thumb allows you to pull the bougie end tip out of the murphy’s eye very easily. I am uploading a vid to vimeo that will detail that (using my homemade intubation model of a wine glass and an upside down remote control device).

    Other issues is holding the ETT, a lubed tip/balloon and contaminating the tip of the bougie when grabbing for the ELM or suction … if you are careful how you hold it, the tip can be kept free in the air. The ETT can also be held proximal to the cuff to avoid lube goobing up your fingers making things slippery (when pulling the bougie tip out of the murphy’s eye however is best by putting your fingers down to ETT tip). As for sterility of the ETT tip, sterile gloves solves that issue but securing airway first is key of course.

    I’ll be doing more tests in the sim lab and upload vids. Love for others to try it, test it, upload vids of it and share their experiences.

    Thanks a million to Jim for the inspiration! The collaboration on developing this idea has been amazing between all of #FOAMed #SoMe: Tim Leeuwenburg saw my sim demo and suggested Kiwi grip. I did another vid on it and Jim saw it and played with it. He shared with me and then Jim, Minh and I chatted it up and examined it over 1-2 days and here we are now!

    May 11, 2013
  2. I quite like this! Great idea Jim and Yen. Jim, looking forward to seeing you at the airway course in a couple of weeks.

    May 12, 2013
  3. thanks

    February 27, 2014

Trackbacks & Pingbacks

  1. d-loop Bougie and a King Vision enabled Mac 4 laryngoscope from Jim DuCanto | PHARM

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Miss Chardy

Laughter in the Outback

The Collective

A Hive Mind for Prehospital and Retrieval Med

Bits & Bumps

Obstetrics and Gynaecology FOAM

FOAMcast

Why FOAM it alone?

Prehospital and retrieval medicine blog

DrGDH

Or "How I'm Learning to Stop Worrying and Love Emergency Medicine"

rain0021

A great WordPress.com site

Genevieve's anthology

Writings to amuse, teach, inspire and entertain.

Prehospital and retrieval medicine blog

Monash Anaesthesia

Prehospital and retrieval medicine blog

Keeweedoc

A topnotch WordPress.com site

BoringEM

Bringing the boring to emergency medicine

resusNautics

Navigating resuscitation

Doctor's bag

by Dr Edwin Kruys

Prehospital and retrieval medicine blog

Prehospital and retrieval medicine blog

ETM Course

Emergency Trauma Management Course

The Doctor's Dilemma

Modern Medical Musings from Dr Marlene Pearce

Sim and Choppers

A blog combining medical education, simulation and helicopter retrieval medicine

GreenGP

Reflections of a Rural GP

Auckland HEMS

Unofficial site for prehospital care providers of the Auckland HEMS service

Rural Doctors Net

useful resources for rural clinicians

expensivecare

Searching for the big picture in intensive care

Nomadic GP

Adventures of a Rural Locum

AmboFOAM

Free Open Access Medical Education for Paramedics

the short coat

Prehospital and retrieval medicine blog

BoringEM

Bringing the Boring to EM

When your shift turns to shit? Keep moving, keep caring!

Kangaroo Island doctor blogging about Rural Medicine in Australia

thebluntdissection

pulling apart cases from the ED...

Little Medic

Learning everything I can from everywhere I can. This is my little blog to keep track of new things medical, paramedical and pre-hospital from a student's perspective.

MEDEST

Prehospital Emergency Medicine

ruralflyingdoc

Just another WordPress.com site

MDaware.org

Prehospital and retrieval medicine blog

Intensive Care Network

Prehospital and retrieval medicine blog

Broome Docs

Rural Generalist Doctors Education

Resus M.E!

Prehospital and retrieval medicine blog

EMCrit Blog - Emergency Department Critical Care

Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation

St Emlyns

Meducation in Virchester #FOAMed

Emergency medicine and critical care medical education blog

RFDS Australia - Queensland Section The STAR Program

Specialised Training in Aeromedical Retrieval

Follow

Get every new post delivered to your Inbox.

Join 7,632 other followers

%d bloggers like this: