Evaluation of a teaching tool to increase the accuracy of pilot balloon palpation for measuring tracheostomy tube cuff pressure. (1st April 2013)

• Record Type: Journal Article
• Authors: Jiang, Nancy; Del, Anthony G.; Iloreta, Alfred M.; Malkin, Benjamin D.
• Is Part Of: Laryngoscope. Volume 123:Number 8(2013:Aug.)
• Page Start: 1884
• Page End: 1888
• Publication Date: 2013-04-01
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.24062
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary24062-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>The purpose of this study was to evaluate the efficacy of a novel teaching tool to improve health care providers' ability to inflate tracheostomy tube cuffs to the appropriate pressure.</p> </sec> <sec id="lary24062-sec-0002" sec-type="section"> <title>Study Design</title> <p>Single‐blinded, randomized, controlled trial.</p> </sec> <sec id="lary24062-sec-0003" sec-type="section"> <title>Methods</title> <p>Subjects were randomized to a control and study group. The control group viewed a video about inflating tracheostomy tube cuffs to safe pressure levels. The study group viewed the same video and also got to palpate the pilot balloons of tracheostomy tube cuffs inflated to three different pressures. All subjects inflated tracheostomy tube cuffs to pressures they believed to be appropriate based on palpation of the pilot balloon preintervention, and immediately, 2 weeks, and 3 months postintervention.</p> </sec> <sec id="lary24062-sec-0004" sec-type="section"> <title>Results</title> <p>Forty‐nine health care providers participated in the study. There was no significant difference in the mean preintervention cuff inflation pressures between the two groups (36 cm H<sub>2</sub>O vs. 38 cm H<sub>2</sub>O, <italic>P</italic> = 0.4888), with both initially overinflating. Postintervention, the study group inflated the cuffs to significantly lower pressures than the control group, closer to the ideal of 25 cm H<sub>2</sub>O (26 cm H<sub>2</sub>O vs. 35 cm H<sub>2</sub>O, <italic>P</italic> = 0.0001). This difference was also observed 2 weeks (28 cm H<sub>2</sub>O vs. 37 cm H<sub>2</sub>O <italic>P</italic> <0.0001) and 3 months (28 cm H<sub>2</sub>O vs. 36 cm H<sub>2</sub>O, <italic>P</italic> = 0.0002) postintervention.</p> </sec> <sec id="lary24062-sec-0005" sec-type="section"> <title>Conclusions</title> <p>The novel teaching tool evaluated in this study is simple, easily reproducible, and low‐cost. Its use leads to long‐lasting improvement in health care providers' ability to more accurately inflate tracheostomy tube cuffs to safe pressures.</p> </sec> <sec id="lary24062-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>1b. Laryngoscope, 123:1884–1888, 2013</p> </sec> </abstract>