Hoffman Robert J, Parwani Vivek, Hahn In-Hei
Department of Emergency Medicine, Beth Israel Medical Center, New York, NY 10003, USA.
Am J Emerg Med. 2006 Mar;24(2):139-43. doi: 10.1016/j.ajem.2005.07.016.
Tracheal necrosis, stenosis, and rupture may result from overinflated endotracheal tube cuffs (ETTcs). We sought to determine the ability of faculty emergency medicine (EM) physicians to safely inflate ETTc as well as to estimate pressure of previously inflated ETTc.
Using a previously tested tracheal simulation model, we assessed EM physician inflation of ETTc pilot balloons. Participants also palpated the pilot balloon of 9 ETTc inflated to pressures ranging from extremely low to extremely high in a random order and reported their estimate of pressure.
We sampled 41 faculty EM physicians from 5 EM residency programs. Using palpation, participants were only 22% sensitive detecting overinflated ETTc. The average ETTc pressure produced by inflation was more than 93 cm H(2)O (normal, 15-25 cm H(2)O).
Participants were unable to inflate ETTc to safe pressures or estimate pressure of ETTc by palpation. Clinicians should consider using devices to facilitate safe inflation and accurate measurement of ETTc pressure.
气管内插管套囊（ETTc）过度充气可能导致气管坏死、狭窄和破裂。我们试图确定急诊医学（EM）科医生安全地为ETTc充气的能力，以及估计先前已充气的ETTc压力的能力。
使用一个先前经过测试的气管模拟模型，我们评估了EM科医生为ETTc的 pilot 球囊充气的情况。参与者还随机触摸了9个充气压力从极低到极高的ETTc的pilot球囊，并报告他们对压力的估计。
我们从5个EM住院医师培训项目中抽取了41名EM科医生。通过触摸，参与者检测ETTc过度充气的敏感度仅为22%。充气产生的平均ETTc压力超过93 cm H₂O（正常范围为15 - 25 cm H₂O）。
参与者无法将ETTc充气至安全压力，也无法通过触摸估计ETTc压力。临床医生应考虑使用设备来促进ETTc的安全充气和准确测量压力。
