In this VETgirl online veterinary CE video, we demonstrate how to check an endotracheal tube (ETT) cuff carefully. This is an important, simple procedure that must be performed on every animal that is intubated. Our goal? To inflate the ETT balloon enough so that aspiration of saliva, flush, or gastric contents does not occur, while making sure to prevent overinflation of the ETT balloon. If overinflated, it can result in severe tracheal necrosis and secondary injury.

After sedating the patient, intubating it, and inflating the ETT cuff, we test the tube’s cuff with the following steps:
1) Closing the pop off valve transiently so we can bag gently up to 20 mm Hg of water to check for a leak (e.g., decrease in pressure).
2) Once there is no evidence of a leak, opening the pop off vale immediately.

When in doubt, this is a must review video for any dental procedure!

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  1. Hi! I have a question about inflating ET tubes. I’ve recently started doing relief work and was helping at a clinic that (in my opinion) was not inflating the tube properly.

    The staff was inflating the ET tube to the point that pressure in the reservoir bag held at 15mm water, but at 20 mm water there was a slight leak around the ET tube.

    I learned that you should inflate until you don’t hear air escaping around the tube and that the pressure on the reservoir bag should hold up to 20mm water (ie- no leak what so ever).

    After talking with the head Dr at this facility, she said that there should be a slight amount of air escaping around the tube at 20, but hold at 15 in order to reduce the risk of tracheal necrosis/tracheal damage.

    Thoughts on this? Hopefully this makes sense.

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