Yen Chow and Jorge Cabrera [Updated Sept 21, 2015]
A cardiac arrest has been called on the floor and you happen to arrive before the crash cart. CPR is in progress and mask ventilation is being performed with an oral airway. A lot of suctioning is required for vomit in the airway. There is difficulty ventilating despite optimizing position, two person bag-valve-mask ventilation, additional nasal airways and maximal jaw thrust. There is limited access to the head of the bed in the patient’s room. As an airway clinician on the code blue team you carry a bougie and a cuffed 6.0 endotracheal tube with you. Intubation and extraglottic airway equipment still has not arrived. Pulling out your bougie and tube, you take out the patient’s dentures and use the oral airway as a bite block. You find the epiglottis with your middle and index fingers inserted into the mouth and guide the bougie into the glottic opening feeling tracheal ticks and hold-up to confirm. The tube slides over the bougie. Successful ventilation occurs without chest compressions missing a beat and the code continues.
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