tracyter

dear fellow nurses, i'm working in the sicu in singapore for three and a half years till date. there are many self extubation cases that happened in my ward as patients are either restless or their cough are very strong till they can cough out the tube. any suggestions of different ways to tape the tube down? how are the extubation rates in your hospital or wards? we only have dura-pores (silk tapes) and zinc oxide tapes and had tried taping around the neck to secure but self extubation rates are still on the upward trend. we even tried restraining patients but patients can still find means and ways to pull out the tube themselves. we have mouth guards that is only used in the emergency dept for trauma patients. can anyone help? it would be even more helpful if anyone could attach pictures or articles.