Endotracheal tube securement

  1. 0
    I am an RN who worked in an ICU a while ago, and there the standard for ET tube securement was adhesive cloth tape. I am now doing a research project and would like to find out how common it is for ICU's to use adhesive tape. Is it still a common practice or is it more common to use an ET tube holder, or even some other method? Also, could you tell me what you find the pros and cons of your ET securement methods?

    Thanks for whatever insight you can provide!

    Get the hottest topics every week!

    Subscribe to our free Nursing Insights newsletter.

  2. 23 Comments...

  3. 0
    i've always used an ET tube stabilizer (the one with the Z shape in the middle, has a little bit of adhesive on the back), on an ambulance and in the ED. much easier than tape, and is better in preventing accidental extubation.
  4. 0
    We use tape and have found that most stablizers don't allow for aggressive mouth care. I would love to see some that do.
  5. 0
    Our ICUs use tape. Just tape.
  6. 0
    We use cloth tapes tied in a particular way. There is some movement to get the EndoTrachead Attachment Device (ETAD) in our ICU which is an adhesive thing - like Comfeel with a zip tie on it.
  7. 0
    Tape is fine in a sedated patient, however you dont want to use it in a patient who is awake in my opinion. You can make a take wrap that goes around the back of their head, however when secretions get on this it often fails to hold the tube after a few days. Tape also allows the tube to move in and out more then a tube tamer doesn
  8. 0
    I work in the sicu, and most often we use ties. Knotted a few times around the tube and then once around the back of the head. We tie a knot near the cheek on one side and put 2x2s near the corner of the mouth to prevent skin breakdown. For patients with neuro injuries (they board down to us sometimes) we use adh. tape.
  9. 0
    Thanks to everyone for all your responses! It's interesting to see the different things being done with ET tubes.

    For everyone who uses tape:
    Could you please tell me how often it is being re-wrapped on each patient?
    Also, what do you think is the best and worst thing about taping the ET tube?

    For those who use devices:
    How often are they changed? Any idea how expensive they are?

    sicushells: Are the ties easy to work with? How quickly can the knots be removed (or do you cut them off?)

    joeyzstj: how do you secure the tube when the patient is awake?
  10. 1
    Quote from findingmywayRN
    Thanks to everyone for all your responses! It's interesting to see the different things being done with ET tubes.

    For everyone who uses tape:
    Could you please tell me how often it is being re-wrapped on each patient?
    Also, what do you think is the best and worst thing about taping the ET tube?

    For those who use devices:
    How often are they changed? Any idea how expensive they are?

    sicushells: Are the ties easy to work with? How quickly can the knots be removed (or do you cut them off?)

    joeyzstj: how do you secure the tube when the patient is awake?

    When a patient is awake we use the tube tamer which is a device that is made specificially for ET tubes for long duration or awake patients. IT has a huge adhesive section that sticks to their cheeks on each side, a track that allows a clip to move the tube from one side of the face to the other if needed and it has a piece of adhesive plastic that wraps around the tube and then claps closed to the tube doesnt slip. Tape is great for surgery where the patient is sedated or for short term ventilation where the paient is sleepy and you are going to extubate when they wake up. We use the actual tamer device until it gets to where its not stick anymore and then we change it or if it looks nasty, we change it. So,basically we change it every three days or so. In my opinion you would need to change out tape more often then that. People very rarely tape and ET tube correctly anyways. The RT's, probably the older ones are the ones you should have show you how.
    Longie likes this.
  11. 1
    Quote from joeyzstj
    When a patient is awake we use the tube tamer which is a device that is made specificially for ET tubes for long duration or awake patients. IT has a huge adhesive section that sticks to their cheeks on each side, a track that allows a clip to move the tube from one side of the face to the other if needed and it has a piece of adhesive plastic that wraps around the tube and then claps closed to the tube doesnt slip. Tape is great for surgery where the patient is sedated or for short term ventilation where the paient is sleepy and you are going to extubate when they wake up. We use the actual tamer device until it gets to where its not stick anymore and then we change it or if it looks nasty, we change it. So,basically we change it every three days or so. In my opinion you would need to change out tape more often then that. People very rarely tape and ET tube correctly anyways. The RT's, probably the older ones are the ones you should have show you how.
    >
    The tube tamer is by far the best device I've seen for holding the ETT. It allows you to move it to avoid breakdown without disconnecting anything. The process for removing the tape without extubating the Pt was risky at best with 2 people. And after a few changes the glue residue will build up on the tube itself.
    Longie likes this.


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

A Big Thank You To Our Sponsors
Top