Airway tubes can be vital. Maybe we can secure them more effectively
Modern medicine demands a constant quest for more efficient and safer ways to deliver care.
An endotracheal tube – a device inserted into a patient’s mouth and guided into the windpipe to maintain an open airway and when patients cannot breathe on their own – is typically kept in place with tape wrapped around it and attached to the patient’s face. If the tube is pulled out accidentally, a patient may suffer from lack of oxygen or other complications.
UCLA anesthesiologists have found that a special device created to keep the breathing tube in position is far more effective and secure than tape.
Their research, published recently in the journal Anesthesia & Analgesia, has the potential to improve the safety and security of endotracheal tubes for patients in the operating room, emergency room and intensive care unit, said Dr. Nir Hoftman, a clinical professor of anesthesiology at David Geffen School of Medicine at UCLA, and one of the study’s authors. Study results are featured on the department’s website.
The anesthesiologists studied a group of patients who needed to be intubated for elective surgery, and who gave their permission to participate. After the breathing tube was properly positioned in the windpipe and secured with tape, the physicians applied a controlled amount of force in an attempt to dislodge it. The tape was then removed and the tube fitted with the new plastic device, called the Haider Tube-Guardâ, which is inserted in the patient’s mouth and includes a clamp to secure the tube. Then the same amount of controlled force was applied.
The results: In 29 of 30 patients, there was clinically significant movement of tubes secured by tape, with nine tubes deemed at high risk of being dislodged. That compares with only one instance of significant tube movement when the tube guard device was used, and no instance of the tube deemed at high risk of being dislodged.
Dr. Hoftman said using the tube guard was “like putting a key in a lock. Once it’s turned, you can’t pull it out.”
The manufacturer provided devices to UCLA anesthesiologists for the purpose of independently conducted research. There was no compensation to patients or commercial funding for the study.
UCLA Health is planning additional tests and evaluating potential wider use of the device, which has U.S. Food and Drug Administration approval.
The soft plastic device – which serves as a bite block as well as a tube holder – was developed by an orthopedic spine surgeon from Riverside, Calif.