aka Anaesthetic Addler 002.1
Here’s a puzzle for all you Airway Sherlock’s to ponder:
An ICU patient’s endotracheal tube was deemed to be sitting too low in the trachea based on a post-intubation chest x-ray. The cuff was deflated and the ETT was withdrawn 2 cm, so that the tip was correctly positioned in the mid-trachea. The cuff was reinflated.
Subsequently, when the cuff pressure was checked, the manometer measured a pressure of zero. Another manometer was used and the same result obtained – zero.
No air leak could be heard on auscultating the neck while the patient was bagged, and there was no air leak detected by the ventilator. The pilot balloon of the endotracheal tube was still inflated and felt firm. The patient remained stable. The manometers worked perfectly when used on other patients.
What has happened?
… and yes, as always, the first correct answer will render the answerer worth of F.UCEM status!