2006 OPEN FORUM Abstracts
ENDOTRACHEAL TUBE HOLDER DEVICE VERSUS TAPE
Authors: Lisa Cracchiolo, RCP, RRT, Barnes-Jewish
Hospital, St. Louis, MO; Donna Prentice, APRN, BC, CCRN, Barnes-Jewish
Hospital, St. Louis, MO; Nancy Lane, APRN, BC, Barnes-Jewish Hospital, St.
Louis, MO; Kitty Bess, RN, Barnes-Jewish Hospital, St. Louis, MO; Donna Clayton,
BS, RRT, Barnes-Jewish Hospital, St. Louis, MO; Marin Kollef, MD, Barnes-Jewish
Hospital, St. Louis, MO
Objective: Determine the safety of the Hollister E-TAD endotracheal
(ET) tube holder to conventional tape.
Design:
Prospective daily evaluation of the positioning of ET tubes. Inclusion criteria;
all intubated patients in the medical intensive care unit (MICU) at Barnes-Jewish
Hospital. Patients had ET tubes secured with either tape or the Hollister E-TAD
ET tube holder. The device used was determined by the bedside clinician (RN/RT)
based on personal preference. Exclusion criterion was any newly-intubated
patient, until confirmation of acceptable initial tube placement.
Method: All intubated patients in the MICU have a
daily morning chest X-ray performed to evaluate patient progress and ET tube
positioning. The attending pulmonary physician or pulmonary fellow read all Chest
X-rays prior to morning rounds. Physicians were blinded to the type of holding
device utilized. The attending physician or pulmonary fellow was asked to
assess the position of the ET tube as to whether it was too low or too high.
Responses were compared with the device used to secure the ET tube.
Results: 488 (285
tape and 203 ET tube holder) observations were completed from October, 2005
until March, 2006. Fifty-three patients (11%) required ET tube repositioning.
Thirty-six patients (12.6%) required repositioning with tape and seventeen
(8.4%) required repositioning with the holder (see below).
| Tube Moved Up | Tube Moved Down | No Change in Tube | |
| Tape (n=285) | 28 (9.8%) | 8 (2.8%) | 249 (87.4%) |
| Holder (n=203) | 8 (3.9) | 9 (4.4%) | 186 (91.6%) |
There is a 000.6 statistical difference in tubes moving up
when utilizing tape compared with utilizing the Hollister E-TAD ET tube holder.
Conclusion: ACLS guidelines state that an ET tube should
be secured with a commercial holding device.
Clinicians are cautious to change from tape, related to the fear of
tubes becoming dislodged. The Hollister
E-TAD ET tube holder is safe and effective, and may provide less movement of ET
tubes compared with tape.