Difficult Airway in an Underequipped Setting

You find yourself in a foreign land on a medical mission with plastic surgeons repairing facial deformities. As the only anesthesiologist, you are in charge of the anesthesia equipment. You are requested to anesthetize a large man (180 kg) for removal of scars from his face. His neck circumference is over 40 cm. You would like to do a fiberoptic intubation, but the patient is terrified and wants to be asleep. You realize that you may need to have a gum elastic bougie as a backup, but discover, to your dismay, that there are none available. You start looking for possible ways of making a bougie from what you have available. The 18-French nasogastric tube would be too soft and the suction catheters you have are too short. Is there anything you can do to make the nasogastric tube stiffer and thereby use it as a bougie?


Nasogastric Tube Plastic Surgeon Neck Circumference Suction Catheter Medical Mission 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Manos SJ, Jaffe RA, Brock-Utne JG. An alternative to the gum elastic bougie and/or the jet stylet. Anesth Analg 1994;79:1017.CrossRefPubMedGoogle Scholar
  2. 2.
    Manos SJ, Jaffe RA, Brock-Utne JG. Airways, paper clips and nasogastric tubes. Anesth Analg 1995;81:208-209.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Personalised recommendations