Cutting Balloon cuffs

Specialties CRNA

Published

I too will ask a clinical question.....

I've always felt strongly about using a syringe to deflate the balloon. There are some I've noticed that have no problem simply cutting or ripping the cuff if a syringe is not readily available. I really notice this in PACU when the patient has just gotten there and is ready for extubation, PACU nurses get kind of impatient when you're grabbing for a syringe to deflate the balloon. How does everyone feel about this? I know that there are different situations where cutting the cuff could cause more problems (in the OR).

About 6 months ago the RT and I extubated in the ICU with the pulmonologist sitting outside the room writing on the chart. When he saw that I had deflated the cuff with the syringe, he said that in the future that he wanted the balloon left inflated--so as to draw out the secretions on top of the cuff.

We just looked at each other with that knowing "what an idiot" look!

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Think about it. What is the average time period between ripping the cuff and extubation?...Seconds. Will all of the air diffuse out of that small lumen between the cuff itself and the syringe connector to the smaller cuff that quickly in such a short period of time? Doubt it. Actively deflating the cuff will provide the least amount of tracheal damage. Why would anyone want to do something so half assed as to not deflate the cuff? I hope that extubator (anesthesia provider, nurse, doctor, etc.) is not taking care of my loved ones.

My motto is: "Do unto your patients as you would have done to you". Okay, enough nerdiness, gotta go.....lml33.

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It's like the Headlights look isn't it? This isue is a no brainer. You should always deflate the balloon.

About 6 months ago the RT and I extubated in the ICU with the pulmonologist sitting outside the room writing on the chart. When he saw that I had deflated the cuff with the syringe, he said that in the future that he wanted the balloon left inflated--so as to draw out the secretions on top of the cuff.

We just looked at each other with that knowing "what an idiot" look!

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I saw the same thing with a foley once. This guy half ripped his catheter out. We could not deflate the balloon, so the wise resident decided to cut the end off--to no avail. Ended up calling the urologist in at 1AM. He held the package up and stuck a needle into the third nut to drain the balloon...freaked all of us out!

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held the package up and stuck a needle into the third nut

:chuckle (!)

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I saw the same thing with a foley once. This guy half ripped his catheter out. We could not deflate the balloon, so the wise resident decided to cut the end off--to no avail. Ended up calling the urologist in at 1AM. He held the package up and stuck a needle into the third nut to drain the balloon...freaked all of us out!

uh . . . WHAT exactly did the urologist do??!!

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The balloon stopped about half way from the bladder to the tip. It looked exactly like he had three testes. First he rammed a hard cath thru the remnants of the foley to possibly break the balloon (no luck). Then he just popped the balloon percutaneously with a needle going thru the scrotum.

Military docs...got to love em!

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I have seen the same thing.. A urologist will insert his finger into the patients rear-end in order to palpate the urine catheter balloon. When he feels it he will then insert a spinal needle into the taint area (he! He!) in order to pop the balloon. The patient did not apopreciate the proceedure, as you may have imagined.

I saw the same thing with a foley once. This guy half ripped his catheter out. We could not deflate the balloon, so the wise resident decided to cut the end off--to no avail. Ended up calling the urologist in at 1AM. He held the package up and stuck a needle into the third nut to drain the balloon...freaked all of us out!
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Yow! My husband's dad is a urologist but I'd be too embarrassed to ask him if he ever did this.

totally off topic - I forget who I heard this from, but apparently they now make fake testes for dogs so their male owners can feel better about neutering them. Someone had a show dog with only one testicle descended, so had one implanted to conceal the defect. The first did eventually drop and the judge at the next dog show was very puzzled!

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totally off topic - I forget who I heard this from, but apparently they now make fake testes for dogs so their male owners can feel better about neutering them.

You mean...neuticles?

http://www.neuticles.com/index1.html

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I might need some of these by the time I graduate...

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I love it! I don't really understand putting them in bulls and horses, but for dogs with, ah, MANLY owners this could be perfect.

Unless you end up with three, of course. That would probably damage your pet's self-esteem even worse than straight neutering. :roll

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