R Kaplow1, M Bookbinder. 1. Memorial Sloan-Kettering Cancer Center, New York, NY.
Abstract
OBJECTIVE: To compare four methods (Lillihei harness, Comfit, Dale, and SecureEasy) of securing endotracheal tubes in orally intubated adult patients in the intensive care unit. DESIGN: Prospective, quasiexperimental. SETTING: University-affiliated oncology critical care unit. SUBJECTS: One hundred twenty-one adult patients who were orally intubated. OUTCOME MEASURES: Endotracheal tube stability, facial skin integrity, patient and registered nurse satisfaction. INTERVENTION: Data collection was conducted on 121 orally intubated subjects. Subjects were evaluated every 12 hours for stabilization of the endotracheal tube and integrity of facial skin. On extubation, patient and nurse satisfaction with the method were assessed. RESULTS: Pearson chi square revealed the SecureEasy holder to be the most secure (p = 0.044). Of all variables that possibly affect extubation, presence of prolonged coughing and gagging had the greatest impact in terms of accidental extubation or dislocation of the endotracheal tube. The fewest incidents of facial skin breakdown occurred with the SecureEasy and Dale holders. Patient complaints regarding discomfort with turning were least common with the Lillihei harness. The SecureEasy holder was associated with the highest degree of nurse satisfaction. CONCLUSIONS: Results of this study suggest that the SecureEasy holder is the preferred alternative method for securing endotracheal tubes when the standard method with tape is not desirable. These results are similar to those reported in a previous investigation in which the adequacy of the SecureEasy holder was assessed.
OBJECTIVE: To compare four methods (Lillihei harness, Comfit, Dale, and SecureEasy) of securing endotracheal tubes in orally intubated adult patients in the intensive care unit. DESIGN: Prospective, quasiexperimental. SETTING: University-affiliated oncology critical care unit. SUBJECTS: One hundred twenty-one adult patients who were orally intubated. OUTCOME MEASURES: Endotracheal tube stability, facial skin integrity, patient and registered nurse satisfaction. INTERVENTION: Data collection was conducted on 121 orally intubated subjects. Subjects were evaluated every 12 hours for stabilization of the endotracheal tube and integrity of facial skin. On extubation, patient and nurse satisfaction with the method were assessed. RESULTS: Pearson chi square revealed the SecureEasy holder to be the most secure (p = 0.044). Of all variables that possibly affect extubation, presence of prolonged coughing and gagging had the greatest impact in terms of accidental extubation or dislocation of the endotracheal tube. The fewest incidents of facial skin breakdown occurred with the SecureEasy and Dale holders. Patient complaints regarding discomfort with turning were least common with the Lillihei harness. The SecureEasy holder was associated with the highest degree of nurse satisfaction. CONCLUSIONS: Results of this study suggest that the SecureEasy holder is the preferred alternative method for securing endotracheal tubes when the standard method with tape is not desirable. These results are similar to those reported in a previous investigation in which the adequacy of the SecureEasy holder was assessed.
Authors: Jonathan J Gamble; William P McKay; Andrew Peeling; Christopher Durr; Trevor Krysak; Rachel Guo; Tanner Lange; Jayden Cowen; Jagmeet S Bajwa Journal: Can J Anaesth Date: 2021-01-12 Impact factor: 5.063