The outside hospital emergency physician passed a bougie through the patient’s existing metal trach and exchanged the metal trach for a 6-0 endotracheal tube. After the exchange, the ETT cuff was inflated, and the patient was connected to a ventilator and transported to our tertiary care center. Upon arrival to our hospital, the position of the ETT was confirmed by passing a fiberoptic bronchoscope through the tube and obtaining direct visualization of the trachea and carina. Once the ETT position was confirmed, an attempt was made to exchange the ETT for a Shiley 6-0 cuffed trach over an Aintree catheter.

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