You need an assistant to feed a tube (usually size 6 cuffed) over the bougie until you can feed it into the trachea. It may be helpful to rotate the tube as you insert it over the bougie to reduce the possibility of hold up at the skin.

The bougie can now be removed, the cuff inflated and the patient connected to a standard 15 mm connection. Remember to use ETCO₂ monitoring to confirm the position of the ETT.

You are much lower down the airway compared with an oral intubation so the ETT only needs to be advanced to approximately the black line at the skin, because it is easy to perform an endobronchial intubation, especially given the stress levels.