Evidence map›Paper›PMID 39904826›Full record

Observational studyCanadian journal of anaesthesia = Journal canadien d'anesthesie2025

Accuracy of tactile bougie use in infrequent intubators: a cadaveric airway study.

Adam Parks, Megi Nallbani, Judah Goldstein, Cory A Munroe, Janel Swain, Sebastien Hebert, Brett Barro, George Kovacs

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Adam ParksDepartment of Emergency Medicine, Dalhousie University, 1796 Summer Street, Halifax Infirmary, 4th Floor ED Admin, Halifax, NS, B3H 3A7, Canada. a.parks@dal.ca.ORCID 0009-0003-5807-6729
Megi NallbaniDepartment of Emergency Medicine, Dalhousie University, 1796 Summer Street, Halifax Infirmary, 4th Floor ED Admin, Halifax, NS, B3H 3A7, Canada.
Judah GoldsteinDivision of Emergency Medical Services, Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada.
Cory A MunroeDepartment of Psychology and Neuroscience, Faculty of Science, Dalhousie University, Halifax, NS, Canada.
Janel SwainSystem Performance, Emergency Health Services, Halifax, NS, Canada.
Sebastien HebertDepartment of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
Brett BarroDepartment of Emergency Medicine, Dalhousie University, 1796 Summer Street, Halifax Infirmary, 4th Floor ED Admin, Halifax, NS, B3H 3A7, Canada.
George KovacsDepartment of Emergency Medicine, Dalhousie University, 1796 Summer Street, Halifax Infirmary, 4th Floor ED Admin, Halifax, NS, B3H 3A7, Canada.

Funding

Research Support, Non-US Gov’t
6 · The paper itself

Abstract

purposeWhen difficulty with laryngoscopy is encountered, confirmation of endotracheal access can be confirmed using the tactile feedback (i.e., tracheal clicks) of a tracheal tube introducer (bougie). There is anecdotal evidence that a bougie placed in the esophagus may have a unique, tactile "boggy" resistance. In this study, we aimed to elucidate the sensitivity and specificity of clicks and boggy resistance for infrequent airway providers in cadaveric airways.

methodsWe conducted a prospective observational study using descriptive statistics to examine the diagnostic accuracy of clicks and boggy resistance for bougies placed in cadaveric airways. We recruited prehospital providers from within Atlantic Canada who then underwent a brief formal training protocol. Cadavers were equipped with a static laryngoscope and bougie (placed either in the trachea or esophagus). Each participant, blinded to bougie placement, was then tested on two separate cadavers and asked whether they felt clicks and/or boggy resistance.

resultsThirty-seven paramedics participated in the study (32 advanced care paramedics, five critical care paramedics) and were randomized to perform 74 bougie assessments on cadaveric airways. For tracheal clicks, we calculated an overall sensitivity of 86% (95% confidence interval [CI], 75 to 98) and an overall specificity of 81% (95% CI, 68 to 94). Sensitivity for the esophageal boggy resistance test was 78% (95% CI, 65 to 92) while specificity was 86% (95% CI, 75 to 98).

conclusionFollowing a brief training session, prehospital providers who intubate infrequently seemed to show a relatively high degree of accuracy using tracheal clicks and esophageal boggy resistance to confirm bougie placement in cadaveric airways.

Indexed as

Airway ManagementIntubation, IntratrachealLaryngoscopyAllied Health PersonnelCadaverCanadaEsophagusFemaleHumansMaleProspective StudiesSensitivity and SpecificityTracheaairway managementbougieendotrachealesophageal intubationintubationparamedics

Identifiers

PMID39904826

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.