Question

1-How would you know that the airway is obstructed in an unconscious patient?

2-How would you keep air in the cuff of an airway which does not have a one-way valve at the pilot balloon?

3-What are some reasons why the cuff may not hold a given volume of air?

4-Why might it be a good idea to use a three-way stopcock arrangement needed to measure cuff pressure?

Answer 1

Ans) 1) Place your ear close to the person's mouth and watch for chest movement. Look, listen, and feel for breathing for 5 seconds. If the person is breathing, give first aid for unconsciousness. If the chest still does not rise, the airway is likely blocked, and you need to start CPR with chest compressions.

2) Cuffed tubes have an external balloon that is connected to the internal cuff by an inflation line. When the external balloon is inflated, the distal cuff inflates and provides a tight seal against the wall of the trachea.

3) The following are indications for cuff inflation: Inflate cuff 24 hours following initial tracheostomy tube placement (prevents accumulation of subcutaneous air and aspiration of secretions) Manual assisted ventilation/mechanical ventilation.

4) The continuous measurement of the pressure was obtained by using the pressure transducer and a 15 cm extension 3-way stopcock was attached to the pilot balloon.

- The transducer was connected to the portable monitor that was connected to a laptop
for recording. Any changes in pressure were recorded as well as activities like turning, suctioning and also coughing.

- Cuff pressures were adjusted when very high and the alarms went off and also when
low and patients were losing their tidal volumes. There was evidence of cuff deflation even during quiet resting times or with no activities.