[Use of the Pentax-AWS videolaryngoscope for bougie-assisted exchange of tracheal tubes].

A gum elastic bougie can be useful for tube exchange. One major problem with this technique is that it may not possible to pass a new tube over the bougie into the trachea, because the tip of the tube can collide with tissues around the glottis. We report a case in which tube exchange using the bougie was difficult, but the Pentax-AWS videolaryngoscope enabled tracheal intubation. In a 62-year-old trauma patient with head and neck stabilized using a Halo vest, was scheduled for emergency fixation of the neck. Exchange of a polyvinylchloride tube to a reinforced tube was planned. A bougie was passed through the old tube, removing the tube, and a new tube was advanced over the bougie, but it was impossible to advance the tube into the trachea. Insertion of a Macintosh laryngoscope did not enable intubation. The new tube was removed from the bougie, attached to the Pentax-AWS videolaryngoscope, and the tube (with the Pentax-AWS) was passed over the bougie. Although it was not possible to see the glottis with the Pentax-AWS, the tube was easily advanced over the bougie into the trachea. Operation went on uneventfully. We believe that, when it is difficult to advance a tracheal tube over a tube exchanger, the use of the Pentax-AWS may facilitate intubation.