The bougie-aided cricothyrotomy.

191 Surgical cricothyroidotomy is considered a critical skill in emergency airway management, though it is rarely used and fraught with complications. A variety of approaches are taught, including both the standard and rapid four-step techniques. We report a case in which an air medical crew used a gum-elastic bougie (endotracheal tube introducer), a common device in many airway kits, to facilitate surgical cricothyroidotomy in a 58-year-old patient with a pharyngeal mass, respiratory failure, and failed rapid sequence induction. We believe this technique may decrease the time until ventilation, minimize complications compared with other cricothyroidotomy techniques, and allow insertion of a larger-diameter endotracheal tube compared with other techniques.