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J Korean Soc Emerg Med > Volume 21(6); 2010 > Article
Journal of The Korean Society of Emergency Medicine 2010;21(6): 795-800.
Effectiveness, Preference and Ease of Passive Release Techniques Using a Syringe for Endotracheal Tube Cuff Inflation
Kyung Choon Park, You Dong Sohn, Hee Cheol Ahn, Ji Yoon Ahn, Seung Min Park, Kwang Yun Cho, Hyuk Sool Kwon, Gyu Chong Cho, Jung Tae Choi
Department of Emergency Medicine, Hallym University College of Medicine, Anyang, Korea. medysohn@hallym.or.kr
Inappropriate cuff inflations cause many complications. A conventional pilot balloon palpation technique is insufficient to detect high cuff pressures, but is still preferred. Hence, we conducted this study to identify effectiveness, preference and ease of use of a new estimation technique named "passive release technique" for endotracheal tube cuff inflation.
Twenty-nine nurses inflated cuffs by a pilot balloon palpation technique in manikins inserted with a 7.5 mm endotracheal tube. Then, being educated about passive release techniques, they inflated cuffs using such a passive release technique. Intracuff pressures and air volumes were measured by manometers and syringes. Preference and ease of use between the two methods were scored using a 10-point Likert scale.
For the pilot balloon palpation technique, only 4 nurses (13.8%) inflated cuffs within the normal range of pressures (normal: 15 to 30 mb) with an average of 39.3+/-34.0 cmH2O. For the passive release technique, 19 nurses (65.5%) inflated cuffs within the normal range of pressures with an average of 24.2+/-9.3 cmH2O (McNemar's test, p<0.01). In the pilot balloon palpation technique, inflated air volumes of 7.8+/-2.0 ml were not significantly different from inflated air volumes 8.5+/-1.2 ml (p=0.07) for the passive release technique. But the difference was found to be statistically significant in a variance ratio test (F-test) (p<0.01). In view of preference and ease of use between the two methods, mean values were not statistically different, 7.3+/-2.0 vs. 7.0+/-2.0 and 7.0+/-2.3 vs. 7.3+/-2.4, respectively.
When direct intracuff measurement is not available, a passive release technique using a syringe is an effective and easy method to achieve cuff inflation.
Key words: Education, Intubation, Pressure
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