Question: How can the anaesthetist determine whether the bougie has entered the trachea, and not the oesophagus, when it has been passed ‘blind’?

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Question: How can the anaesthetist determine whether the bougie has entered the trachea, and not the oesophagus, when it has been passed ‘blind’?

Answer: Clicks can be felt, as the bougie passes over the tracheal rings.

If no clicks are felt then the bougie should be carefully advanced further to a distance of 45 cm - the bougie’s passage will be met with resistance as it enters the bronchial tree. The patient may also cough if not completely relaxed. If none of these occur, then it is highly likely the bougie is in the oesophagus.