Best Method for Securing an Endotracheal Tube.

CEN, CFRN, CPEN, and Tom Pietrantonio, BSRT, RRT-RCP, reply: In a study published in Respiratory Care, Shimizu et al3 concluded that the conventional adhesive tape methods had greater extubation force than the 2 endotracheal tube holders and that extubation force varies considerably depending on the width, length, and type of adhesive tape used. Mohammed and Hassan4 studied endotracheal tube slippage at various time intervals when twill versus adhesive tape was used to secure the tube. They reported that at 120 minutes after the tube was secured, 73% of patients in the twill group had no slippage but only 36% of patients in the adhesive groups had no slippage. Tasota et al5 concluded that both internal and external movement of endotracheal tubes was significantly less with commercial endotracheal tube holders than when conventional noncommercial taping methods were used. As a result, nursing staff expressed a higher level of acceptance of commercial endotracheal tube holders as the method of choice for securing endotracheal tubes.