Max pressure on an intubation cuff

[essedus]

Hello all. I could not find in neither my med-surg nor my fundamentals book the maximum pressure of a cuff on an endotracheal or tracheostomy tube. Also I saw some readings on the net in mmHg and mmH2o and was wondering how they compare. Please let me know what the appropriate pressure is and if possible please cite your sources.

Thanks a bunch.

[nuangel1, BSN, RN]

in our icu we used 5-7 cc just enough so when you listened you didn't hear a cuff leak ie sealed .but rt would check cuff press q shift and adjust and chart the vol in cuff on their records .

[Charity, RN, APRN]

Don't think checking cuff pressure isn't important. We had a 7 y/o arrive from a city 35 miles away--intubated in the field, direct admit to our PICU. Our RT's first action was to check the cuff and to deflate it. She said the pressure was way too high. He had been tubed about an hour, but the damage was done. He developed tracheomalacia from the compression of the cuff. He was in and out of the hospital for years, working to overcome his problem. Happy to say he now has a stable airway, no trach.

[essedus]

Thank you all for responding and thank you RRTM2 for citing. Very helpful.

[littleevil1]

I agree, I'm actually a respiratory student, 25mmhg is the max you want to put in, you want to start with 10ml and then start measureing by the cuff manometer. When you hear a minimal leak at the trach during their peak inspiration - that is when you know you have it perfect for that patient. :monkeydance:

[mom2angelson]

:yeah:Everyone on this site is so helpful. Getting checked off on cuff pressure Tuesday. It helps to have a refresher. 3rd semester respiratory & it's great to know, we all work together for a common goal. Great patient care.

Thank you!