2003 OPEN FORUM Abstracts
Comparative Evaluation of Two Endotracheal Tube Securing Methods
Douglas S Gardenhire MS RRT, Ruben D Restrepo MD RRT. Department of Cardiopulmonary Care Sciences. Georgia State University; Atlanta, Georgia.
Background: Even though there are a variety of methods to secure an endotracheal tube (ETT), evaluation of their safety and efficacy is limited. The method most commonly used to secure an endotracheal tube in a patient is the adhesive cloth tape (CAT). There are, however, various endotracheal tube holders that claim to ease the process of securing the endotracheal tube and be more effective and safer than the regular adhesive cloth tape. The ET Adhesive Tape TM (MarPac, Albuquerque, NM) is composed of a soft, cotton/foam Latex-free neck band that utilizes hypoallergenic adhesive tape. Our study compared the conventional adhesive cloth tape with the MarPac system.
Methods: Thirty-one junior-year respiratory students from our baccalaureate program volunteered to participate in the study. They were instructed on appropriate use of both methods to secure an ETT by the same faculty. Evaluation of both methods was achieved by comparing the time students spent securing an ETT on a Laerdel mannequin. Subjective parameters such as ease of use, and control of the ETT were assessed by using a Likert scale. Safety and security of both methods were evaluated by measuring displacement of the ETT at different weight loads in the laboratory. Pairwise comparisons and descriptive statistics were analyzed using SPSS statistical software.
RESULTS: Most participants strongly agreed that the commercial ETT holder was easier to apply than the conventional adhesive tape (53% vs. 11% respectively) and gave the commercial product the higher overall ratings. There was a statistically significant difference between both methods when time of application and ETT displacement at different weight loads were analyzed.
CONCLUSION: The results of this study suggest that the MarPac tape can sustain a greater load before ETT displacement, is observed and less overall time to apply than the CAT. The MarPac device would be more appropriate in emergency situations where time and stability is of the essence. We would recommend the Marpac as a Class IIB recommendation as observed by the American Heart Association when intubation of a patient is needed. Although the study discovered statistically significant differences between the CAT and the MarPac device, a prospective randomized comparative clinical study to test both methods is necessary. Variables such as facial skin integrity, ETT displacement, rate of inadvertent extubation, cost analysis, patient and clinician satisfaction, also need to be evaluated.