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Bougie assisted intubation via SGA with Dr Jim Du Canto

Thumbnail image for A Guide to Intubating through the Intubating Laryngeal Airway by James DuCanto

Jimmy D is back with a video on intubation via a supraglottic airway but with a novel twist!

SO what you say? Bougie assisted intubation via a LMA has been done before..sure thing. But what have we added or described further here …? See for yourself. Will this technique spell the death of RSI as we know it?

Incredible stuff, right? Whats so novel about what you just saw?

1. Almost all the airway gear shown is commonly available in every ICU, ED , OT or prehospital EMS service

2. The use of a swivel endoscopic connector allows for continuous ventilation throughout the procedure

3. Adding a video laryngoscope or optical stylet is the most expensive part of the whole technique but allows you to use the device alone or combined in this hybrid technique of SGA and VL assisted bougie intubation

4. This technique allows a SGA device to be exchanged for an ETT, during CPR for example.



4 Comments Post a comment
  1. Name: Tim Leeuwenburg
    Comment: Awesome video and I especially impressed that this is an anaesthetist (or is that anaesthesiologist) who ‘gets’ the whole issue of (a) emergency airway management from the ED/ICU/prehospital perspective and (b) utilises bits of kit that are available, affordable and robust in these same environs.

    The whole idea of a staged procedure in those for whom intubation via direct laryngoscopy is difficult/impossible makes sense.

    Yeah, the purists will say should place an ETT via laryngoscopy with Mac blade every time (I’ve recently had two people tell me they’ve ‘never failed’ to intubate – I suspect they have not done enough…)…or should use a flexible fibreoptic scope for an AFOI…or cancel the case and wake up the patient…or shouldn;t be doing airway management at all. They miss the point

    Well done chaps, this is gold

    Time: Thursday May 17, 2012 at 8:01 pm

    May 19, 2012
  2. Absolutely brilliant!

    May 20, 2012
  3. 2 questions re: LMA+VL+bougie (if anyone is still reading this):

    1) if the patient is PEEP-dependent, will introduction of VL disrupt LMA seal and de-recruit?

    2) will this work with indirect/angulated VL blades (eg Glidescope, MacGrath Series 5, Storz D blade)?

    July 10, 2012

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