Comparison of Commercial and Noncommercial Endotracheal Tube-Securing Devices

Year in Review 2014: Patient Safety

“…Traditional methods of tube fixation required similar extubation forces as devices commercially available in the United States. Unlike the study by Fisher et al, 13 Wagner et al 14 did not measure the force applied to the face.…”

Best Method for Securing an Endotracheal Tube

“…Studies have demonstrated that commercial devices tends to be more usable than noncommercial methods. Fisher et al 7 reported that it took less time to move the endotracheal tube when commercially available devices were used than when noncommercial techniques were used.…”

“…However, the force exerted on the patient's face by many of the commercial securing devices may result in discomfort and formation of pressure ulcers, whereas noncommercial techniques are more form-fitting and do not have the same pressure point issues as seen with commercial devices. 7 …”

Projecting Clinical Insight From Quality Simulation Data

“…By extrapolation from data presented by Fisher et al, 5 the risks and benefits between devices may be tailored to SEE THE ORIGINAL STUDY ON PAGE 1315 the individual patient population. Whereas surgical patients may require endotracheal intubation for only a few hours to a few days, patients with debilitating lung disease may require prolonged endotracheal intubation.…”

“…4 Although their data were based on simulation, their conclusions were generated on 1,600 observations and a series of controls to avoid bias between devices and techniques, leading to an extremely high quality data set. 5 One may extrapolate these data for clinical application, although ultimate clinical validation will also be required. If the results from this study do correlate with clinical patterns for skin breakdown related to ETT-securing devices, these data could indeed lead to a clinical injury risk assessment tool.…”