Subjective Versus Objective Measurement of ETT Cuff Pressures in the Operating Room: A Quality Improvement Project

Abstract

With a variety of adequate techniques to choose from, there is a lack of understanding of provider’s preferences for selection of a subjective versus an objective measurement technique for monitoring ETT cuff pressures during surgical procedures requiring an ETT. The purpose of this quality improvement project was to assess anesthesia providers’ perceptions of perioperative usefulness of subjective assessment (tactile) and objective assessment (manometer) of occlusive volume for ETT cuffs. Participants in this study were Certified Registered Nurse Anesthetists. Participation in this study involved taking a short pre-intervention questionnaire about their current practice of checking ETT cuff pressures, watching an educational video on the purpose of ETT cuff pressure measurement, completing a post-intervention questionnaire after a two week implementation period. Findings showed most participants thought their current technique of subjective measurement was sufficient and accurate in obtaining ETT cuff pressures. They reported the objective measurement strategy of using a manometer was adequate, however they reported their expected future use to be less than 50 percent of the time. The primary limitation of this project was related to the small sample size. With three participants, data is not necessarily reflective of the anesthesia profession as a whole. As this project was performed over a time period of only two weeks, the limited amount of time to assess anesthesia providers’ preferences is also a significant limitation. For further study, a project that involves having participants use their preferred measurement strategy (likely subjective) followed by measurement with a manometer (objective) to assess the adequacy of their initial strategy for comparison is suggested.