Procedure Guides

Airway Management - Cuff Replacement Technique

1 Sandpaper tube to remove excess adhesive.

Peel away as much damaged cuff from the endotracheal tube as possible. After removing old cuff material, use light sandpaper to remove excess adhesive and smooth tube

2 Slide cuff onto tube

After the tube has been sanded and thoroughly cleaned, wet tube in a basin of water.Wet the replacement cuff and slide the cuff onto the tube. Water will help the cuff slide more easily into position. Slide the replacement cuff along the tube until it is in the same position as the old cuff. Smooth the cuff, ensuring there are no wrinkles or curled edges before applying the adhesive.

3 Squeeze adhesive under the cuff

Prepare your syringe with adhesive. Remove the syringe plunger and squeeze 3-5 cm of adhesive into the syringe barrel. Replace the plunger and attach the tapered blue adaptor to the syringe nozzle. Insert the tapered end of the adaptor under the proximal edge of the cuff and gradually squeeze out the adhesive in a continuous coating under the cuff.

4 Use wooden tip to roll out adhesive

After the adhesive has been placed under the edge of the cuff, wet the wooden end of a swab stick to prevent adhesive sticking to it. Gently roll the wooden end of the swab stick over the edge of the cuff working out the excess adhesive. Remove excess adhesive with moistened fingers. Repeat steps 3 and 4 with the distal end of the cuff.

5 Smooth glue around cuff

Place another bead of adhesive on top of the proximal cuff edge and smooth with fingers dipped in water. Repeat this on the distal end of the cuff.

6 Allow adhesive to cure

Place the endotracheal tube so the distal tip is elevated and the cuff is not touching any other material and leave adhesive to set overnight at room temperature. Check for leaks before use.

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