The inability to correctly position the patient may cause difficulty during oral endotracheal intubation. Examples of such circumstances include cases of suspected cervical spine injury and cases of restricted access to the patient in the prehospital environment. The Eschmann tracheal tube introducer, more commonly called the "gum elastic bougie," is a valuable aid to oral intubation. The case reported herein, of a successful bougie-assisted oral intubation in the prehospital setting, highlights the usefulness of the technique. Physicians considering the use of the gum elastic bougie for intubation difficulties after rapid sequence induction should seek specific training in the use of the instrument. [Nocera A: A flexible solution for emergency intubation difficulties. Ann Emerg Med May 1996;27:665-667.]