Befriend the bougie!

OK people, time to share.

Following on from befriend the bougie! @MDaware shared a great tip about using the bougie to assist in intercostal catheter placement in obese patients. Indeed, I suggested that the bougie is so fantastic, if there is a hole, it is probably worth sticking a bougie in it one time or another. Whereupon @GrahamWalker claimed that the bougie-assisted rectal examination is not to be sniffed at (he may have been joking, it can be hard to tell with Americans…).

Here are some cool pics that Graham Walker took in the SimLab demonstrating the use of a bougie to place an intercostal catheter. I’ve only tried this technique once in 2009, and it worked nicely. If there doesn’t seem like there is much bougie sticking out the end (e.g. an obese patient) you can shorten the intercostal catheter with scissors by trimming the end that will remain outside the patient. Don’t have a chest tube handy? You can use an endotracheal tube as a chest tube replacement (e.g. in austere environments).

bougie chest tube

Which leads us to the present.

I want LITFLers to share their best, most inventive, most creative and most useful uses for a bougie. Don’t be shy, there could be an honorary Fellowship of UCEM on offer!

Leave a comment below.

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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