2012 OPEN FORUM Abstracts
THE ASSESSMENT OF CUFF PRESSURE MEASUREMENTS UTILIZING THREE CLINICAL TECHNIQUES.
Christopher Russian, Joshua F. Gonzales; Respiratory Care, Texas State University-San Marcos, San Marcos, TX
Rationale: The minimal occluding volume technique (MOV), the minimal leak technique (MLT), and direct pressure measurement (DPM) are ways to manage the cuff of an artificial airway. All three techniques are included on national board exams and are used daily by Respiratory Care Practitioners. The MOV and the MLT are bedside techniques that manage cuff pressures without the aid of a manometer. DPMs are also performed at bedside utilizing a manometer. The purpose of the research is to determine which of the technique provides the most accurate and most consistent cuff pressure measurement. Methodology: Students in the Department of Respiratory Care at Texas State University-San Marcos volunteered to participate in performing 2 MOV and 2 MLT techniques. The techniques were performed on a manikin receiving mechanical ventilation through a 7.0 endotracheal tube. Following the performance of these techniques, researchers then measured the cuff pressure set by the student using a cuff manometer. Next students attempted to set cuff pressure at 30 cmH2O at peak inspiration using the DPM technique. Following their attempt researchers once again measured and recorded their results. Results: Mean results were calculated for the MOV, MLT, and DPM techniques. The MOV technique averaged 16 cmH2O with a range varying from 2 cmH2O to 34 cmH2O. The MLT technique displayed a lower mean pressure measurement. Its recorded mean resulted in 10 cmH20 with a range of 2cmH2O to 22 cmH2O. Of the three techniques, DPM was the most consistent. Mean pressure measurements were 30 cmH2O with a range of 26 cmH2O to 32 cmH2O. Conclusion: Although all three techniques have been shown to be effective in cuff pressure measurements, our research demonstrated great variations between practitioners. As expected, DPM proved to be the most consistent form of cuff pressure measurement. The MLT and MOV techniques demonstrated a wide range of numbers as different respiratory care students performed each technique. While all three methods are accepted in clinic practice, practitioners should be aware of the inconsistencies between individuals performing these maneuvers. Our results stress the importance of continuing education and repeated practice if the MLT and MOV maneuvers are included in the policy and procedure for cuff pressure monitoring. When performing a MLT or MOV technique we recommend verifying pressure measurements via a cuff manometer periodically throughout the shift. Sponsored Research - None