title: Prehospital endotracheal intubation; need for routine cuff pressure measurement?
abstract: In endotracheal intubation, a secured airway includes an insufflated cuff distal to the vocal cords. High cuff pressures may lead to major complications occurring after a short period of time. Cuff pressures are not routinely checked after intubation in the prehospital setting, dealing with a vulnerable group of patients. We reviewed cuff pressures after intubation by Helicopter Emergency Medical Services and paramedics noted in a dispatch database. Initial cuff pressures are almost all too high, needing adjustment to be in the safe zone. Dutch paramedics lack manometers and, therefore, only few paramedic intubations are followed by cuff pressure measurements. We recommend cuff pressure measurements after all (prehospital) intubations and, therefore, all ambulances need to be equipped with cuff manometers.
authors.affiliation: Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands. j.peters@chir.umcn.nl
authors.forename: Joost H
authors.initials: JH
authors.lastname: Peters
authors.forename: Nico
authors.initials: N
authors.lastname: Hoogerwerf
mesh_terms: D017732:Air Ambulances / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000379:methods; D008365:Manometry / Q000295:instrumentation; D009426:Netherlands; D011312:Pressure / Q000009:adverse effects*; D012189:Retrospective Studies; D017751:Safety Management / Q000592:standards
keywords: emergency ambulance systems; emergency care systems; paramedics; prehospital care; prehospital care, helicopter retrieval