UMMS Affiliation

Department of Emergency Medicine

Publication Date

2017-06-01

Document Type

Article

Disciplines

Emergency Medicine

Abstract

INTRODUCTION: Over-inflation of endotracheal tube (ETT) cuffs has the potential to lead to scarring and stenosis of the trachea.1, 2,3, 4 The air inside an ETT cuff is subject to expansion as atmospheric pressure decreases, as happens with an increase in altitude. Emergency medical services helicopters are not pressurized, thereby providing a good environment for studying the effects of altitude changes ETT cuff pressures. This study aims to explore the relationship between altitude and ETT cuff pressures in a helicopter air-medical transport program.

METHODS: ETT cuffs were initially inflated in a nonstandardized manner and then adjusted to a pressure of 25 cmH2O. The pressure was again measured when the helicopter reached maximum altitude. A final pressure was recorded when the helicopter landed at the receiving facility.

RESULTS: We enrolled 60 subjects in the study. The mean for initial tube cuff pressures was 70 cmH2O. Maximum altitude for the program ranged from 1,000-3,000 feet above sea level, with a change in altitude from 800-2,480 feet. Mean cuff pressure at altitude was 36.52 +/- 8.56 cmH2O. Despite the significant change in cuff pressure at maximum altitude, there was no relationship found between the maximum altitude and the cuff pressures measured.

CONCLUSION: Our study failed to demonstrate the expected linear relationship between ETT cuff pressures and the maximum altitude achieved during typical air-medical transportation in our system. At altitudes less than 3,000 feet above sea level, the effect of altitude change on ETT pressure is minimal and does not require a change in practice to saline-filled cuffs.

Keywords

endotracheal tube cuffs, altitude, helicopter transport, emergency medical services

Rights and Permissions

Copyright : © 2017 Weisberg et al

DOI of Published Version

10.5811/westjem.2017.3.32078

Source

West J Emerg Med. 2017 Jun;18(4):624-629. doi: 10.5811/westjem.2017.3.32078. Epub 2017 May 15. Link to article on publisher's site

Journal/Book/Conference Title

The western journal of emergency medicine

Related Resources

Link to Article in PubMed

PubMed ID

28611883

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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