8 thoughts on “Bougie Intubation with the Kiwi-DuCanto Grip”
Good work Ric and Larry! The technique you are describing is the Kiwi-DuCanto grip. I go through the Murphy eye by feeding the bougie back through the tip of the ETT, then out the Murphy eye. This technique is really starting to take off, especially with paramedic organizations (esp. on Long Island NY from what I’m told here). Your video education module is an awesome contribution to improve the quality of first pass attempts at tracheal intubation!
It’s interesting to see this evolve. A very useful technique, but does require operator and assistant to know how to set it up – dont make your first time be in anger!
I recall learning it from Paul Baker of ANZCA Difficult Airway SIG….he’s a Kiwi, and I think Rick Levitan used to refer to it as the ‘Kiwi grip’ in homage to Paul (a New Zealander). There have been modifications since, by luminaries of the Airway Illuminato such as Yen Chow and Jim DuCanto
Interestingly I spoke to Paul Baker about this…and he reckoned it was good ol’ Prof Frova who first described this – as a special manoeuvre for the Frova bougie that bears his name!
So…is it the “Frova-Kiwi-DuCanto” grip? Who knows….interesting how small iterative changes lead to improvement
I reckon using this technique speeds up my first pass RSI by a couple of seconds – avoids that tedious ‘hang up’ on ETT connector, espec for occasionalists
Reblogged this on MEDEST and commented:
Love this tecnique. Consider Kiwi grip tecnique for every direct or video intubation and in alternative to stylet use. You will be surprised on how easy and effective this tecnique is.
I know going against the zeitgeist here but that looked a right faff to me. Perhaps personal opinion/tip but the most helpful thing when using a bougie is for the assistant to pull the right hand corner of the mouth directly laterally, this gives a larger working space and improves the ability to manipulate the bougie massively.
Another bug bear of mine is preloading the ETT onto the bougie with the syringe attached it often swings around and is distraction, the few seconds taken to load the ETT onto the bougie and manipulate past the cords with a 90 degree twist as you railroad it means that hold up virtually never occurs. I am a Consultant anaesthetist and intensivist from Scotland with a regular difficult airway theatre list, and so get the issues about intubations outside of theatre potentially being more tricky. But you know what I use the same skillset whatever geographic location.
Ultimately I guess if it works for you and your patient go for it, but often simpler solutions to these “new” problems are already known and taught at least in UK anaesthetic practice.
It is a perfect an easy intubation techniqe. I watch it and it’s amezing. We are using right know the old technique and is verry difficult. The camera is verry well too. We use only our eye for cam. This technique is vell. I like it.
Thank you.
It is a perfect an easy intubation techniqe. I watch it and it’s amezing. We are using right know the old technique and is verry difficult. The camera is verry well too. We use only our eye for cam. This technique is vell. I like it.
Thank you.
It is a perfect an easy intubation techniqe. I watch it and it’s amezing. We are using right know the old technique and is verry difficult. The camera is verry well too. We use only our eye for cam. This technique is vell. I like it.
Thank you..
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Good work Ric and Larry! The technique you are describing is the Kiwi-DuCanto grip. I go through the Murphy eye by feeding the bougie back through the tip of the ETT, then out the Murphy eye. This technique is really starting to take off, especially with paramedic organizations (esp. on Long Island NY from what I’m told here). Your video education module is an awesome contribution to improve the quality of first pass attempts at tracheal intubation!
Thanks for clarifying ! I have updated the post title
It’s interesting to see this evolve. A very useful technique, but does require operator and assistant to know how to set it up – dont make your first time be in anger!
I recall learning it from Paul Baker of ANZCA Difficult Airway SIG….he’s a Kiwi, and I think Rick Levitan used to refer to it as the ‘Kiwi grip’ in homage to Paul (a New Zealander). There have been modifications since, by luminaries of the Airway Illuminato such as Yen Chow and Jim DuCanto
Interestingly I spoke to Paul Baker about this…and he reckoned it was good ol’ Prof Frova who first described this – as a special manoeuvre for the Frova bougie that bears his name!
So…is it the “Frova-Kiwi-DuCanto” grip? Who knows….interesting how small iterative changes lead to improvement
I reckon using this technique speeds up my first pass RSI by a couple of seconds – avoids that tedious ‘hang up’ on ETT connector, espec for occasionalists
Keep those airway tips coming…
Reblogged this on MEDEST and commented:
Love this tecnique. Consider Kiwi grip tecnique for every direct or video intubation and in alternative to stylet use. You will be surprised on how easy and effective this tecnique is.
I know going against the zeitgeist here but that looked a right faff to me. Perhaps personal opinion/tip but the most helpful thing when using a bougie is for the assistant to pull the right hand corner of the mouth directly laterally, this gives a larger working space and improves the ability to manipulate the bougie massively.
Another bug bear of mine is preloading the ETT onto the bougie with the syringe attached it often swings around and is distraction, the few seconds taken to load the ETT onto the bougie and manipulate past the cords with a 90 degree twist as you railroad it means that hold up virtually never occurs. I am a Consultant anaesthetist and intensivist from Scotland with a regular difficult airway theatre list, and so get the issues about intubations outside of theatre potentially being more tricky. But you know what I use the same skillset whatever geographic location.
Ultimately I guess if it works for you and your patient go for it, but often simpler solutions to these “new” problems are already known and taught at least in UK anaesthetic practice.
It is a perfect an easy intubation techniqe. I watch it and it’s amezing. We are using right know the old technique and is verry difficult. The camera is verry well too. We use only our eye for cam. This technique is vell. I like it.
Thank you.
It is a perfect an easy intubation techniqe. I watch it and it’s amezing. We are using right know the old technique and is verry difficult. The camera is verry well too. We use only our eye for cam. This technique is vell. I like it.
Thank you.
It is a perfect an easy intubation techniqe. I watch it and it’s amezing. We are using right know the old technique and is verry difficult. The camera is verry well too. We use only our eye for cam. This technique is vell. I like it.
Thank you..