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.