Maintaining cuff pressure

[chani]

greetings from Down under

As some of you may know we dont have RTs in ICU in Australia so the nurses are responsible for most respiratory care including ETT management. At present I am reviewing the evidence for ETT cuff pressure management. I would like to ask who uses intermittent or continuous direct measurement and if anyone is using continuous control.

I have looked through past posts and cannot find this question there.

For continuous measurement you might like to read Mary-lou Sole's recent publications

http://ajcc.aacnjournals.org/content/18/2/133.short

http://www.aacn.org/WD/CETests/Media/A1120023.pdf

EVALUATION OF AN INTERVENTION TO MAINTAIN ENDOTRACHEAL TUBE CUFF PRESSURE WITHIN THERAPEUTIC RANGE AJCC

cheers

[BelgianRN]

Hey There,

In my institution we use intermittent checks with a hand held manometer that gives us the cuff pressure in cmH2O. As per institutional guidelines we have to keep it between 20 and 30 cmH2O. In our PDMS we have to document the cuff pressure every 4 hours, but personally I'll check it every time I'm at my patient to register his vitals and do the ins and outs etc. Normally that is every two hours.

If I find that my cuff pressure fails to keep in the required range for 4 hours I'll generally warn the intensivist and have a reintubation planned during "office hours" if it's not a major leak issue and when reintubation is possible (e.g. I'll think twice when my patient is on an FiO2 of 1.0 and iNO and PEEP 15 cmH2O...). I work in Belgium and we don't have RT's either.

[Jtsqueek]

Hi there South African RN here,we also do not have RT's, we use a handheld manometer to measure the cuff pressure atleast 4 hourly, the aim is to keep it between 20 - 30 cmH2O, leaking cuffs are reported but very rarely are tubes actually changed,unless the leak is severe, more often then not the nurse is left to "top up" the cuff prn