Cuff pressure monitoring by manual palpation in intubated patients: How accurate is it? A manikin simulation study. Issue 4 (July 2017)

• Record Type: Journal Article
• Authors: Giusti, Gian Domenico; Rogari, Cecilia; Gili, Alessio; Nisi, Fulvio
• Is Part Of: Australian critical care. Volume 30:Issue 4(2017)
• Page Start: 234
• Page End: 238
• Publication Date: 2017-07
• Subjects: Nurse education -- Cuffed endotracheal tube -- Intracuff pressure -- Monitoring-cuff pressure -- Intensive care units -- Equipment-cuffs -- Manikin study; Intensive care nursing -- Periodicals; Intensive care nursing -- Australia -- Periodicals; Electronic journals; 616.028
• DOI: 10.1016/j.aucc.2016.10.001
• Languages: English
• ISSNs: 1036-7314

Abstract

Abstract: Background: Endotracheal intubation (ETI) for mechanical ventilation has a central role in the Intensive Care Unit (ICU). ETI is one of the main risk factors for the development of ventilator-associated pneumonia (VAP) as its presence reduces the natural defences of the upper airway and allows the micro-suction of secretions in the airways. In order to minimise such complications, it is fundamental to maintain a suitable pressure inside the tube cuff. Aim and scope: The main objective of the present study is to evaluate the effectiveness and reliability of palpation method, performed with the operators fingers, for detecting the tube cuff pressure. Results: The study was performed using a manikin to test the pressure of the ETT cuff, on a sample constituted by nurses employed in three Italian ICU from two different Umbrian hospitals. From a total of 68 participants, detection by palpation method revealed to be not correct in 68% of cases; in particular, only 10% of respondents can correctly detect a pressure in the recommended range (20–30 cmH2 O) using palpation. Moreover it was possible to highlight that the participation in emergency courses has a positive effect on the correct measurement of cuff pressure using the palpation method (V = 0.501). Conclusions: The study, in agreement with the literature, confirms the thesis that the palpation method is inadequate to determine an estimate of the pressure existing inside the cuff.