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HomeGrown Solution: Leaky Endotracheal Tube Cuff

Title

Leaky Endotracheal Tube Cuff

Submitted By

Jaan Hwan Chong

HomeGrown Solution Number

351

Identification of the Problem

Endotracheal tube (ETT) leaks are a potential life-threatening crisis. Leaky ETTs trigger a ventilator response, which prompts learners to determine the ETT failure and execute emergency airway management.

Unique Idea

This technique explores a learners' resourcefulness in solving airway crisis in anesthesiology, emergency and intensive care practices.

Objectives

  • Introduce a simulation that replicates an airway crisis
  • Provide a high fidelity opportunity to recognize and intervene in an airway crisis

Supplies/Ingredients

  • Endotracheal tube with cuff
  • Fine (29G) needle
  • Patient simulator with laryngospasm
  • Intubation kit
  • Ventilator

Steps to Creating the Solution

  1. Assess the manikin's laryngospasm mechanism.

  2. Puncture the ETT cuff with a fine (29G) needle.

  3. Intubate the manikin with the punctured ETT and place the ETT cuff along to the laryngospasm cuff.

  4. Trigger laryngospasm to sandwich ETT cuff and inflate the ETT cuff via pilot balloon.

  5. Replace the manikin's neck skin and attach the ventilator for positive pressure ventilation.

  6. Have learners verify the pilot balloon pressure while the manikin's laryngospasm is switched on.

  7. Shut the laryngospasm to present ETT leaks.

  8. The ventilator will detect a loss of pressure and alarm. Present apnea parameters while learners verifying ETT leakage.

Images

endotracheal tube cuff being punctured with a 29G needle uncovered manikin neck with airway hole uncovered manikin neck with endotracheal tube cuff adjacent to the neck uncovered manikin neck with endotracheal tube cuff being squeezed by a person's hand mechanical ventilator in use

Video

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