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Fig. 1 | Critical Care

Fig. 1

From: Bougie-in-channel intubation technique

Fig. 1

Bougie-in-channel intubation technique. a Attach the disposable channeled blade to the videolaryngoscope. b Allow the patient’s neck to be in the neutral position. c Insert the videolaryngoscope into the oral cavity and visualize the glottic opening. d Insert the flexible bougie into the guiding channel of the disposable videolaryngoscope blade (that is, bougie-in-channel technique). e Advance the flexible bougie into the trachea. f While holding the videolaryngoscope in place, shift the bougie laterally out of the channel. g While holding the videolaryngoscope in place, railroad a lubricated endotracheal tube down the bougie until resistance is felt at the arytenoids and then pull the endotracheal tube back by about 2 cm. h While holding the videolaryngoscope in place, rotate the endotracheal tube 90° toward the patient’s left side (the bougie must be allowed to freely rotate together with the tube). i While holding the videolaryngoscope in place, advance the endotracheal tube until the black indicator line is at the level of the vocal cords. j While holding the videolaryngoscope in place, rotate the endotracheal tube back to the neutral position. k While holding the videolaryngoscope in place, remove the bougie. l While holding the videolaryngoscope in place, inflate the cuff. m While holding the videolaryngoscope in place, connect the tube to a ventilation device. n While holding the videolaryngoscope in place, confirm ventilation by chest auscultation. o Remove the videolaryngoscope. p Secure the endotracheal tube

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