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Malleable intubating guide

In cooperation with Prof. Dr. Patrick Schoettker from the University Hospital of Lausanne / Switzerland VBM has developed a new malleable intubating guide – the S-Guide.


Very versatile in its indications, the S-Guide can be used during conventional as well as video laryngoscopy. It works especially well with the non-channelled video laryngoscope blades.


The design of the S-Guide unifies all the essential specifications that are usually split between introducers and stylets. This makes it the ideal tool to overcome a diffi cult airway scenario.



The apnea can be prolonged through oxygen flow via O2 Connector. The 23 cm of flexible segment eases connection to the oxygen source without impacting placement of the S-Guide.


The malleable segment allows the S-Guide to be adjusted to any required geometry starting after the orange tip and up to 42 cm. The hockey stick shape at the distal end and the right angle at the level of the tracheal tube connector can be easily achieved without compromising oxygenation.

Multifunctional tip

Preformed, soft and coloured distal tip enhances patient safety. 3 outlets for O2 administration provide oxygenflow to prevent hypoxia.

Size Length for ET Tube
15 Fr 65 cm ≥ I.D. 6.0 mm

S-Guide - The orotracheal tube dance

The use of malleable stylets or bougies to assist orotracheal intubation is an integral part of difficult airway algorithms. Their use in routine intubation might also be on the rise with the recent development of video laryngoscopy. Manoeuvrability at the distal end of the orotracheal tube may be necessary to allow advancement beyond the glottic opening into the trachea.


The special stiffness of the S-Guide qualifies it for the technique of the orotracheal tube dance*.
By combining rotation of the orotracheal tube and withdrawal of the S-Guide, a three-dimensional dancing motion of the distal end of the tube can be achieved (Figs. 1 and 2).


The S-Guide should be lubricated and shaped “straight-to-cuff“ with a bend angle at the black mark approaching 35°. Its withdrawal will move the tip of the tube anteriorly while tube rotation will lead to extremity “dancing“. The orange marked tip may protrude past the distal end of the tracheal tube.


These conjoint manoeuvres of dynamic S-Guide intubation under videolaryngoscopic view can be extremely helpful in tracheal intubation owing to difficulty in tube advancing beyond the glottic opening, modified anatomy or oropharyngeal tumours.

Figure 1

Rotate tube while withdrawing S-Guide.

Figure 2

A three-dimensional tube dance is achieved.

Downloads and further information

Vimeo Videolink:  S-Guide

Vimeo Videolink:  S-Guide with portable videolaryngoscope

  • Grape, S / Schoettker, P:. The role of tracheal tube introducers and stylets in current airway management. J Clin Monit Comput. 2016 Apr 16.
  • *Schoettker, P.: The orotracheal tube dance. Eur J Anaesthesiol. 2015 Jun; 32(6): 443-4.
  • Batuwitage, B. et al: Comparison between bougies and stylets for simulated tracheal intubation with the C-MAC D-blade videolaryngoscope. Eur J Anaesthesiol 2014
  • Apfelbaum, JL et al: Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2013; 118: 251-70
  • Evans, H. et al: Tracheal tube introducers: choose and use with care. Anaesthesia 2010; 65: 859

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