The Bougie and First-Pass Success in the Emergency Department

Brian Driver, Kenneth Dodd, Lauren R. Klein, Ryan Buckley, Aaron Robinson, John W. McGill, Robert F Reardon, Matthew E. Prekker

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Study objective The bougie may improve first-pass intubation success in operating room patients. We seek to determine whether bougie use is associated with emergency department (ED) first-pass intubation success. Methods We studied consecutive adult ED intubations at an urban, academic medical center during 2013. Intubation events were identified by motion-activated video recording. We determined the association between bougie use and first-pass intubation success, adjusting for neuromuscular blockade, video laryngoscopy, abnormal airway anatomy, and whether the patient was placed in the sniffing position or the head was lifted off the bed during intubation. Results Intubation with a Macintosh blade was attempted in 543 cases; a bougie was used on the majority of initial attempts (80%; n=435). First-pass success was greater with than without bougie use (95% versus 86%; absolute difference 9% [95% confidence interval {CI} 2% to 16%]). The median first-attempt duration was higher with than without bougie (40 versus 27 seconds; difference 14 seconds [95% CI 11 to 16 seconds]). Bougie use was independently associated with greater first-pass success (adjusted odds ratio 2.83 [95% CI 1.35 to 5.92]). Conclusion Bougie was associated with increased first-pass intubation success. Bougie use may be helpful in ED intubation.

Original languageEnglish (US)
Pages (from-to)473-478.e1
JournalAnnals of Emergency Medicine
Issue number4
StatePublished - Oct 2017

Bibliographical note

Publisher Copyright:
© 2017 American College of Emergency Physicians


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