Flexible Eschmann Stylet

Eschmann Stylet is a narrow diameter tracheal tube introducer with an outer diameter of 5 mm. often called the gum elastic bougie, it is not made of gum nor is it elastic, the original design is made of beige colored resin covering a fiberglass core. The total length of the original version is 60 cm and the distal tip blends at an angle of 38 degrees. The Eschmann Stylet is flexible but has some shape retention.  It is best handled by keeping the distal half as straight as possible, inserting the upturned distal Coude tip under the epiglottis or, preferably, above the interarytenoid notch if it is visible. Some operators grip the bougie as a pencil, place the device with their right hand, and retain their laryngoscope in the left,allowing an assistant to railroad a tracheal tube into proper position. The narrow diameter provides easier target visualization and its small upturned distal tip can be given a curved upward shape to facilitate passage under the epiglottis.

The tracheal tube introducer is used to facilitate difficult intubation. It should not be confused with the more rigid stylet, which is inserted into the ET tube and used to alter its shape prior to intubation. Unlike the stylet a bougie is inserted independently of the ET tube and is used as a guide. Since the bougie is considerably softer, more malleable, and blunter than a stylet this technique is considered to be a relatively atraumatic procedure. Numerous case reports and case series attest to the value of the Eschmann Stylet in difficult in tubation in the operating room and more recently in emergency medicine practice.