4. Inflation and Deflation

4. Inflation and Deflation

This is preferably done using a dedicated air-filled 60ml syringe, as the whole cuff may be inflated in one go to its recommended 60mls volume, saving time. Initially, this should be done to over-inflation, as per the pre-use checks.

The Tulip is designed to be “one-size-fits-all-adults” and is designed to be “insert-to-fit” and “inflate-to-fit”.

If the Tulip is introduced partially inflated (+/-30mls), then topping-up the total air volume within the cuff to +/-60mls may be required to achieve an unobstructed ventilating airway. In addition, partially inflated Tulip’s may require a chin-lift or a head-extension to be performed to achieve a clear ventilating airway, as mucosal and oropharyngeal structures may have not been expanded out of the breathing tubes way by the inflatable cuff, thus enabling clear, unobstructed ventilation. The partially inflated Tulip may provide a ventilating airway for low pressure ventilation even when partially inflated. Partial inflation will also reduce the intra-cuff pressure to very low levels (<40cmH2O/29mmHg).

Full inflation (+/- 60mls) after introduction, whether inserted deflated or partially inflated, is deemed necessary to achieve a stable, unobstructed, ventilating airway without any manipulations of the head, neck or jaw.

It is recommended that the Tulip be inflated to +/- 60mls volume in all Patients initially to gain a rapid, stable, ventilating airway, and then the intra-cuff pressure reduced to below 54cmH2O (40mmHg) for sustained use to allow mucosal perfusion to be maintained. Ventilating pressures of +/-20cmH2O are usually still possible with a Tulip even when running very low intra-cuff pressures (+/-29mmHg, +/-40cmH2O). If higher ventilating pressures are required, simply increase the Tulip intra-cuff pressure until it stops leaking audibly at that given ventilating pressure. The Tulip has lower intra-cuff pressures than other devices, so any elevation of the pressure within the cuff to achieve a seal will not usually cause any harm to the Patient, as the pressures within the cuff are still likely to be less than alternative equipment. Intra-cuff pressures should be monitored at all times as the Tulip is a high performance device and its cuff may hold approximately 1000mls of air. The recommended inflation volume of the Tulip is +/-60mls with a maximum inflation volume of 80mls total.