Feeling Tracheal Rings with Dr. Talwalkar's Bougie is helping a lot more than other bougies like Portex in difficult intubation cases. Tips for better usage are: 1. Traverse your bougie along the epiglottis and feel the tracheal rings for confirmed intubation. 2. If you are in the oesophagus, the bougie passes uninterruptedly into the stomach without any feel. 3.
If the bougie feels tracheal rings and stops at the carina or at Lewis angle level on sternum (from outside) — you are intubating right. 4. Too much bend at the tip of bougie troubles the passage of ET tube. 5. Assistant should hold one end a little firm, and manipulate glottis or Adam's apple or thyroid cartilage from outside with the other hand. With a cool mind and presence of mind, bougie intubation becomes easy.
