A low-cost steerable bougie could help doctors insert an emergency endotracheal breathing tube into a patient’s windpipe. 

 

Developed at Nottingham Trent University (United Kingdom), the steerable endotracheal bougie is intended for patients who are in intensive care or under a general anesthetic, and is designed to serve as an alternative to the standard gum elastic bougie (GEB) when negotiating the pharynx during difficult endotracheal intubation, facilitating access to the larynx. Once in place, the endotracheal tube is lowered over the bougie and into the trachea. The endotracheal tube may also be placed over the bougie prior to intubation, instead of using a stylet. 

 

The new steerable bougie incorporates two Felxinol (a nickel-titanium shape memory alloy) wires, which are situated in the long, disposable malleable plastic casing. When heat is applied to one of the wires via an electric current it shortens in length, thus enabling the flexible tip to be moved by more than 120 degrees within the space of a second. The bending and steering procedure is controlled via a detachable handle which can be fully controlled by a single person. 

 

“We think that this invention has real potential to fill a unique and sizeable gap in the market. The design is fully compatible with the endotracheal tubes currently used by the NHS, and we expect it will be cost-effective to manufacture,” said co-designer Luke Siena, PhD, a postgraduate researcher at the school of architecture, design, and the built environment. “Our ultimate aim is for it to be used routinely by clinicians and help improve the way that patients are dealt with in what can be very difficult situations for medical staff.”