A COMPARISON OF 4 ENDOTRACHEAL-TUBE HOLDERS

Objective: To compare four methods (Lillihei harness, Comfit, Dale, an d SecureEasy) of securing endotracheal tubes in orally intubated adult patients in the intensive care unit. Design: Prospective, quasiexperi mental. Setting: University-affiliate oncology critical care unit. Sub jects: 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 collec tion was conducted on 121 orally intubated subjects. Subjects were eva luated every 12 hours for stabilization of the endotracheal tube and i ntegrity of facial skin. On extubation, patient and nurse satisfaction with the method were assessed. Results: Pearson chi square revealed t he SecureEasy holder to be the most secure (p = 0.044). Of all variabl es 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 s kin breakdown occurred with the SecureEasy and Dale holders. Patient c omplaints regarding discomfort with turning were least common with the Lillihei harness. The SecureEasy holder was associated with the highe st degree of nurse satisfaction. Conclusions: Results of this study su ggest that the SecureEasy holder is the preferred alternative method f or securing endotracheal tubes when the standard method with tape is n ot desirable. These results are similar to those reported in a previou s investigation in which the adequacy of the SecureEasy holder was ass essed.