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Updated: Aug 10, 2026

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Gum elastic bougie, capnography and apnoeic oxygenation
F A Millar1, G L Hutchison, R Glavin
1Department of Anaesthesia, Ninewells Hospital, Dundee DD1 9SY, UK.
Background And Aim:
This study assessed the accuracy of using capnography with a modified, hollow gum elastic bougie in predicting tracheal intubation, and its effectiveness as a method of apnoeic oxygenation.
Methods:
Patients were randomly allocated to having the gum elastic bougie inserted, under anaesthesia, in the trachea or the oesophagus. End-tidal carbon dioxide measurements were made at 10 and 20 s. The position of the gum elastic bougie was correctly predicted in 89.2% of patients. We tested the apnoeic oxygenation on an anaesthetic simulator model, which is housed in the Scottish Anaesthesia Simulator Centre, Stirling, UK.
Results:
The time taken for the oxygen saturation to fall to 90% was significantly prolonged when the gum elastic bougie was used for apnoeic oxygenation.
Conclusion:
The modification of the gum elastic bougie allows a more objective assessment of correct placement than the previous tactile method. The current design of bougie is unsuitable but can be modified.
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