The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

UTILIZATION OF ANCHOR FAST ORAL ENDOTRACHEAL TUBE FASTENER TO REDUCE THE INCIDENCE OF LIP ULCERS

Kenneth J. Miller, Linda Cornman, Chris Fenstermaker, Angela Lutz, Diane Limoge, Georigiann Morgan, Hungarter Donna; Respiratory care, LVHN, Allentown, PA

Introduction: Endotracheal intubation is a common clinical intervention in the critical care environment. Unfortunately, endotracheal intubation is not without complications, even when instituted with expertise and diligently maintained. One of the complications of endotracheal intubation is the development of lip ulcerations secondary to maintaining a patent and secure airway. The development of a lip ulcers has been identified as both a patient safety issue and added financial burden. Another issue with endotracheal tube security is the time requirements placed on the clinical team to change and re-apply endotracheal tube fasteners or tape. Methods: Anchor Faster Endotracheal Tube Fastener (Hollister, Illinois, USA) was utilized to maintain a secure airway on sixteen patients placed on mechanical ventilation over an eight week period. Criteria for utilization were any patient with an anticipated intubation and mechanical ventilation for greater than twenty-four hours. The incidence of lip ulcers and the number of times the endotracheal tube was moved were recorded. Below is the pre/post-Anchor Fast data: Post Anchor Fast data is noted in bold text: Results: After institution of the Anchor Faster Endotracheal Tube Fastener, there was a 25-82% reduction in the occurrence of lip ulcers in the assigned patient population. Incidence of Ventilator-Associated Pneumonias and ventilator days remained unchanged. There was a trend towards a reduction of tape changes, with an associated decrease of clinician time devoted to changing tape. There was no increase of inadvertent or accidental extubations. Conclusion: Based our clinical trial the Anchor Faster Endotracheal Tube Fastener is a safe alternative to securing an artificial airway. In this pilot study there was a reduction of lip ulcers with no increase of accidental extubation or Ventilator-Associated Pneumonia. Also the application of the Anchor Faster Endotracheal Tube Fastener may reduce clinician time utilized to re-adjust or re-apply endotracheal holders or adhesive. More research needs to be applied to a larger patient population to support the above results. Sponsored Research - None

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