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Prehospital endotracheal intubation; need for routine cuff pressure measurement?
  1. Joost H Peters1,
  2. Nico Hoogerwerf2
  1. 1Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
  2. 2Department of Anesthesiology, Radboud University Medical Centre, Nijmegen, The Netherlands
  1. Correspondence to Joost H Peters, Department of Surgery, Radboud University Medical Centre, Geert Grooteplein Zuid 10, Nijmegen 6525 GA, The Netherlands; j.peters{at}


In endotracheal intubation, a secured airway includes an insufflated cuff distal to the vocal cords. High cuff pressures may lead to major complications occurring after a short period of time. Cuff pressures are not routinely checked after intubation in the prehospital setting, dealing with a vulnerable group of patients. We reviewed cuff pressures after intubation by Helicopter Emergency Medical Services and paramedics noted in a dispatch database. Initial cuff pressures are almost all too high, needing adjustment to be in the safe zone. Dutch paramedics lack manometers and, therefore, only few paramedic intubations are followed by cuff pressure measurements. We recommend cuff pressure measurements after all (prehospital) intubations and, therefore, all ambulances need to be equipped with cuff manometers.

  • emergency ambulance systems
  • emergency care systems
  • prehospital care, helicopter retrieval
  • paramedics
  • prehospital care

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