Date of Award
Doctor of Nursing Practice (DNP)
Cheryl D. Schlamb, DNP, CRNP
Cheryl Monturo, PhD, MBE, ACNP-BC
Stephen Lawless, MD, MBA
The prehospital use of cuffed endotracheal tubes has become an evidence-based practice recommendation. Uncuffed endotracheal tubes continue to be used by emergency medical services (EMS) that transport injured and ill children to Nemours/Alfred I Dupont Hospital for Children (N/AIDHC). Uncuffed endotracheal tubes are being used in infants and toddlers, but also in older children and adolescents. EMS agencies that refer patients to N/AIDHC were surveyed to determine the status of their implementation and use of cuffed endotracheal tubes. Of six services, two had fully implemented the use of cuffed endotracheal tubes. Dispositional resistance to change among the EMS administrators was measured and found to be lower at the services that had implemented the use of uncuffed endotracheal tubes. Implementation of the use of cuffed endotracheal tubes was most facilitated by clinical expert involvement. Outreach education by pediatric critical care experts is indicated to assist those services that have not yet implemented the use of cuffed endotracheal tubes.
Pearson, Thomas E., "Prehospital Use of Cuffed Endotracheal Tubes in Pediatric Patients: Thematic Analysis of Barriers to Practice Change." (2020). West Chester University Doctoral Projects. 64.