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The ‘Umbrella Furling’ Deflation Technique for Cuffed Tracheostomy Tube - A Useful Tip for An Easier Tracheostomy Insertion
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  • Estelle How Hong,
  • Lucy Li,
  • Omar Hilmi,
  • Kerry Haddow
Estelle How Hong
NHS Tayside

Corresponding Author:[email protected]

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Lucy Li
Queen Elizabeth University Hospital
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Omar Hilmi
NHS Greater Glasgow and Clyde
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Kerry Haddow
NHS Tayside
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Key points: • When deflated, folds often form in the balloon cuff of a tracheostomy tube resulting in additional friction when inserting the tube. • Furthermore, this potentially increases the risk of cuff rupture, particularly in patients with calcified tracheas and iatrogenic tracheal injury from using excessive physical force when inserting a tracheostomy tube. • The ‘Umbrella Furling’ technique for deflating the cuff of a tracheostomy tube is a simple approach whereby the cuff is slowly deflated with a damp gauze wrapped around it while simultaneously twisting the tracheostomy tube. • This enables the deflated cuff to sit flush to the tube, therefore allowing an easier “reduced-friction” insertion of a cuffed tracheostomy tube and reducing the risk of damage to the cuff. • The same technique can be used to facilitate the insertion of endotracheal tubes through an enclosed laryngoscope.