An Emergency Cuff Inflation Technique

A leaky cuff on an endotracheal or tracheostomy tube necessitates reintubation. Patients who are unstable and dependent on mechanical ventilation or who have had cervical-spine or upper-airway trauma are at particular risk during an emergency reintubation. Oftentimes, however, the problem is a cracked one-way valve or cut pilot balloon or cuff-inflating tube. I have found that in these cases a simple, fast procedure that uses readily available supplies can be used to reinflate the cuff. A device constructed of a 10-ml syringe, stopcock, and needle can be easily assembled and used to bypass the leaking one-way valve to fill the cuff and measure intracuff pressures. I have used such a device several times and the patients suffered no observed ill effects. Although this technique seems to have been independently discovered by some practitioners, a search of nursing and respiratory therapy literature has failed to reveal an article on the subject.