Cuff pressure

The tracheostomy cuff (when present) provides a seal to enable mechanical ventilation.

It also provides some protection against aspiration of secretions from the upper airway.

Over-inflation of the cuff may cause damage to the trachea. Conversely, too little pressure places the patient at risk of aspiration and difficulties with mechanical ventilation due to persistent air leak.

The pressure within the cuff should be checked once a shift or as required with a hand-held pressure manometer and should be maintained between 20 – 25cmH2O.

To check the cuff pressure:

  1. Connect the pilot line to a manometer and take a measurement.
  2. If the pressure is outside the target range 20 – 25cmH2O, it will need adjusting using a syringe.
  3. Using a 10ml syringe inserted into the end of the pilot balloon, add or remove air as required.
  4. Recheck the cuff pressure using the manometer.
  5. Repeat until the pressure is inside the target range 20 – 25cmH2O.
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