Journal Watch Emergency Medicine
Copyright © 2007. Massachusetts Medical Society

Every paramedic in this study inflated the cuff above the safe limit, and 87% could not detect an overinflated cuff by palpation of the pilot balloon.

Overinflation of an endotracheal tube (ETT) cuff can lead to severe complications, including tracheal necrosis, laryngeal nerve palsy, and tracheo-esophageal fistula, whereas underinflation can lead to inadequate ventilation from air leaks and aspiration. In a prospective, observational, cross-sectional simulation study, researchers assessed paramedics’ ability to inflate an ETT cuff to a safe pressure and to estimate the pressure of previously inflated cuffs by palpation of the pilot balloon.

After performing a simulated intubation, each participant assessed cuff pressure, and then a researcher measured actual pressure using a cuff inflation device. In a second phase of the study, participants palpated, in random order, nine ETT pilot balloons with pressures ranging from 0 to 120 cm H2O and indicated whether the pressure was too low, appropriate, or too high.

Full Story: Most participants could not detect an overinflated ETT, study says