Use and care of an endotracheal / tracheostomy tube cuff - are intensive care unit staff adequately informed? : intensive care

ABSTRACT

Background. There is an apparent high incidence of tracheal stenosis in the Bloemfontein area. The aim of this study was to determine intensive care unit (ICU) staff knowledge of the use and care of endotracheal and tracheostomy tube cuffs. Methods. One hundred and twelve qualified nurses; working in 11 different ICUs; were asked to complete an anonymous questionnaire regarding endotracheal / tracheostomy tube cuffs. Results. The results highlight the following three areas of concern (i) there was an overall misconception in 38of the respondents that the function of the cuff was to secure the tube in position in the trachea to prevent selfextubation; (ii) accurate regulation of cuff pressure was not routine practice in any of the ICUs; and (iii) only half of the respondents felt their training regarding cuff care management was sufficient. Conclusions. ICU staff had misconceptions regarding the function and care of endotracheal / tracheostomy tube cuffs. The concept of a higher cuff pressure for better stabilisation of the tube is probably an important factor that could have caused the increase in tracheal stenosis in the Bloemfontein area. Critical care nursing needs to emphasise the use of current techniques; discourage routine cuff deflation; and encourage collaboration with ICU physicians on standards of care. A protocol that could be used in the ICUs regarding the use and care of an endotracheal / tracheostomy tube cuff is proposed