Instead of using a bougie, or just blindly exchanging a cuffed tracheostomy. make sure this tracheostomy tube has been in place more than one week.
Less traumatic. Less likely to cause a crack in the trachea that can lead to Massive Subcutaneous Emphysema.
Topics discussed on prior posts by me.
Freshly placed tracheostomies, less than 1 week may have not epithelialized enough and false tracts are commonly made when blind exchanges are done. Those need fiberoptics to truly make sure you are in the lumen of the trachea. Expensive to get a CT scan to confirm you are in the right place.