CPR protocol: in case of arrest would you extubate the uncuffed and intubate with a cuffed ET tube?

RE: CPR protocol: in case of arrest would you extubate the uncuffed and intubate with a cuffed ET tube?

jenni99 — Mon, 01 Apr 2024 17:21:42 GMT

My thoughts exactly, and the patient is getting 100 oxygen, as opposed to the 21ish % in air

RE: CPR protocol: in case of arrest would you extubate the uncuffed and intubate with a cuffed ET tube?

kazrussell2002 — Sun, 31 Mar 2024 21:33:59 GMT

Thank you! This is what I have written in the protocol

RE: CPR protocol: in case of arrest would you extubate the uncuffed and intubate with a cuffed ET tube?

Katherine Spear — Sun, 31 Mar 2024 21:31:47 GMT

In an arrest situation I definitely wouldn't be spending time extubating, I would keep that airway if already intubated and be working on CPR.

RE: CPR protocol: in case of arrest would you extubate the uncuffed and intubate with a cuffed ET tube?

kazrussell2002 — Sun, 31 Mar 2024 21:24:06 GMT

Thank you so much - I never expected to receive a voucher! So not only did I get help with this topic, needed as I was reviewing our protocol, but I also had a lovely surprise too. Fantastic community thank you

RE: CPR protocol: in case of arrest would you extubate the uncuffed and intubate with a cuffed ET tube?

Nick Shackleton — Fri, 08 Mar 2024 22:19:10 GMT

Generally use uncuffed tubes in cats. In a crash situation I wouldn’t go to the trouble to change the tube. Time is of importance with CPR and feel it is more beneficial to the patient to start chest compression and ventilation. I wouls of only change an ETT if capnogrpah was showing signs of improper intubation or obstruction.

RE: CPR protocol: in case of arrest would you extubate the uncuffed and intubate with a cuffed ET tube?

apache — Thu, 07 Mar 2024 23:01:52 GMT

The idea of an uncuffed tube is a larger diameter tube can be used. If the person placing the tube isn't fitting a larger uncuffed tube then they are doing it wrong. I'd be far more concerned about small tubes and inhalational gas leakage rather than whether it was possible to deliver sufficient O2 and breaths during CPR (which is unlikely to be unsuccessful). The animal can live on 21% oxygen, on 100% you are getting more than enough in, even with some minor tube leakage.

Using a cuffed tube with the cuff deflated is the worse of both worlds. Smaller diameter to deliver and remove gas and environmental leakage. Either used cuffed and cuff it gently or go uncuffed. No reason to change tube for CPR (or to give breaths) UNLESS you have reason to doubt the tube. Hopefully you have a capnograph so are aware of blockage.

RE: CPR protocol: in case of arrest would you extubate the uncuffed and intubate with a cuffed ET tube?

kazrussell2002 — Wed, 06 Mar 2024 20:55:52 GMT

Agree, just got to convince the workplace this may be a better way of doing things

RE: CPR protocol: in case of arrest would you extubate the uncuffed and intubate with a cuffed ET tube?

Louise Royle RVN CertCFVHNut — Wed, 06 Mar 2024 15:38:49 GMT

We use a cuffed et tube too, and only inflate if required for CPR. I think it is safer to maintain the air way you have than risk loosing it by extubating / re intubating with cuffed tube.

RE: CPR protocol

Arlo Guthrie — Wed, 06 Mar 2024 11:18:24 GMT

kazrussell2002 and pingi (and everyone else!)

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RE: CPR protocol

pingi — Tue, 05 Mar 2024 23:19:05 GMT

We use a cuffed et tube but don’t inflate it unless emergency.