Utility of Cuff Palpation in the Verification of Endotracheal Tube Positioning

Kim, Hyun Ju; Bae, Hyun A; Jung, Koo Young

Abstract

PURPOSE: To confirm the utility of cuff palpation for the verification of the correct endotracheal tube position.
METHODS
One hundred and one intubated patients were selected randomly every three days among the 344 intubated patients in the emergency room of a tertiary care hospital between July 2006 and March 2007. After endotracheal intubation was confirmed, we recorded the probability of successful cuff palpation. We also measured the patient's weight, height and neck length; the distance from ETT tip to the incisors, and distance from ETT tip to the carina of the patients. Sedatives or muscle relaxants that used were used were noted as well.
RESULTS
In the cuff palpated group (n=61), 40 patients' had the ETT tip at 3~5cm from the carina while in the nonpalpated group (n=40), 35 patients had the ETT tip placed at less than 3 cm or more than 5 cm from the carina (p value <0.001). The cuffs of the ETTs inserted in patients whose neck lengths were below 10 cm were less palpable than in patients whose neck lengths were more than 10 cm.(p=0.004) There was no relation between cuff palpability and height, BMI and use of muscle relaxant or sedatives. In addition, 9 of 10 cases whose cuffs were non-palpable, which were randomly chosen among the non-palpated group (n=40) with incorrectly positioned cuff became palpable after the repositioning of the ETT.
CONCLUSION
We concluded that cuff palpation is a simple and reproducible way to verify the correct depth of endotracheal tubes.