• Am J Emerg Med · Mar 2006

    Experienced emergency medicine physicians cannot safely inflate or estimate endotracheal tube cuff pressure using standard techniques.

    • Robert J Hoffman, Vivek Parwani, and In-Hei Hahn.
    • Department of Emergency Medicine, Beth Israel Medical Center, New York, NY 10003, USA. rjhoffman@pol.net
    • Am J Emerg Med. 2006 Mar 1;24(2):139-43.

    ObjectiveTracheal necrosis, stenosis, and rupture may result from overinflated endotracheal tube cuffs (ETTcs). We sought to determine the ability of faculty emergency medicine (EM) physicians to safely inflate ETTc as well as to estimate pressure of previously inflated ETTc.MethodsUsing a previously tested tracheal simulation model, we assessed EM physician inflation of ETTc pilot balloons. Participants also palpated the pilot balloon of 9 ETTc inflated to pressures ranging from extremely low to extremely high in a random order and reported their estimate of pressure.ResultsWe sampled 41 faculty EM physicians from 5 EM residency programs. Using palpation, participants were only 22% sensitive detecting overinflated ETTc. The average ETTc pressure produced by inflation was more than 93 cm H(2)O (normal, 15-25 cm H(2)O).ConclusionsParticipants were unable to inflate ETTc to safe pressures or estimate pressure of ETTc by palpation. Clinicians should consider using devices to facilitate safe inflation and accurate measurement of ETTc pressure.

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