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Endotracheal Tube Cuff Pressure – Comparison of the Two Filling Methods – Simulated Test

Published online by Cambridge University Press:  30 April 2021

Tomasz Ilczak Open the ORCID record for Tomasz Ilczak [Opens in a new window] ,
Michał Ćwiertnia Open the ORCID record for Michał Ćwiertnia [Opens in a new window] ,
Piotr Białoń Open the ORCID record for Piotr Białoń [Opens in a new window] ,
Michał Szlagor Open the ORCID record for Michał Szlagor [Opens in a new window] ,
Beata Kudłacik Open the ORCID record for Beata Kudłacik [Opens in a new window] ,
Małgorzata Rak Open the ORCID record for Małgorzata Rak [Opens in a new window] ,
Szymon Bialka Open the ORCID record for Szymon Bialka [Opens in a new window] ,
Adam Ubych Open the ORCID record for Adam Ubych [Opens in a new window] ,
Arkadiusz Stasicki Open the ORCID record for Arkadiusz Stasicki [Opens in a new window]  and
Wioletta Waksmańska Open the ORCID record for Wioletta Waksmańska [Opens in a new window]
...Show all authors
Tomasz Ilczak
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Emergency Medicine, Bielsko-Biala, Poland
Michał Ćwiertnia*
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Emergency Medicine, Bielsko-Biala, Poland
Piotr Białoń
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Emergency Medicine, Bielsko-Biala, Poland
Michał Szlagor
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Emergency Medicine, Bielsko-Biala, Poland
Beata Kudłacik
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Emergency Medicine, Bielsko-Biala, Poland
Małgorzata Rak
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Emergency Medicine, Bielsko-Biala, Poland Department of Toxicology, Nofer Institute of Occupational Medicine, Łódź, Poland
Szymon Bialka
Affiliation:
Śląski Uniwersytet Medyczny w Katowicach, Department of Anaesthesiology and Critical Care, Zabrze, Katowice, Poland
Adam Ubych
Affiliation:
Śląski Uniwersytet Medyczny w Katowicach, Department of Anaesthesiology and Critical Care, Zabrze, Katowice, Poland
Arkadiusz Stasicki
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Emergency Medicine, Bielsko-Biala, Poland
Wioletta Waksmańska
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Public Health, Bielsko-Biala, Poland
Jan Bujok
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Biochemistry and Molecular Biology, Bielsko-Biala, Poland
Monika Mikulska
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Emergency Medicine, Bielsko-Biala, Poland
Rafał Bobiński
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Biochemistry and Molecular Biology, Bielsko-Biala, Poland
Marek Kawecki
Affiliation:
University of Bielsko-Biala, Faculty of Health Sciences, Department of Emergency Medicine, Bielsko-Biala, Poland
*
Correspondence: Michał Ćwiertnia, University of Bielsko-Biala, Faculty of Health Sciences, Willowa 2, 43-309Bielsko-Biala, Poland, E-mail: mcwiertnia@ath.bielsko.pl
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Abstract

Introduction:

Tracheal intubation is the optimal method for opening up airways. Performed correctly, it prevents stomach contents from entering the respiratory tract and allows asynchronous cardiopulmonary resuscitation (CPR) to be conducted during sudden cardiac arrest. An important element of correct intubation is proper inflation of the endotracheal tube cuff. Research has shown that when medical personnel use the palpation technique, the cuff is usually inflated incorrectly. This can result in numerous health complications for the patient.

Methods:

This research was conducted in 2020 on a group of paramedics participating in the 15th International Winter Championship of Medical Rescuers in Bielsko-Biala (Poland). The aim of the research was to assess two methods of inflating the endotracheal tube cuff. Method A involved inflating the cuff using a syringe and assessing the pressure in the control cuff using the palpation technique. Method B involved inflating the cuff using a manometer. During the inflation, both the cuff inflation pressure and the time required to complete the procedure were recorded. Analysis was also conducted on whether completion of certified Advanced Life Support (ALS) and Advanced Cardiovascular Life Support (ACLS) training had any influence on the effectiveness of the inflation procedure.

Results:

The research showed that paramedics using Method B significantly more often inflated the endotracheal tube cuff to the correct pressure than those using Method A. However, when Method B was used, the procedure took longer to conduct. The study also showed that completion of certified ALS or ACLS training did not have a significant influence on proper inflation of the cuff. Those who had completed certified training courses took significantly longer to inflate the endotracheal tube cuff when using Method A.

Conclusions:

Inflation of the endotracheal tube cuff by use of a syringe, followed by the palpation technique for assessing the inflation of the cuff balloon, is ineffective. Paramedic teams should be equipped with manometers to be used for inflating the endotracheal tube cuff.

Keywords

cuff pressureintubationparamedic
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 4 , August 2021 , pp. 421 - 425
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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