Effect of airway-securing method on prehospital endotracheal tube dislodgment.

Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors
Douglas F KupasHenry E Wang

Abstract

We compared the effectiveness of common airway-securing techniques in preventing endotracheal tube (ETT) dislodgment in the prehospital setting. This was a prospective, observational, multicenter study conducted at 42 emergency medical services (EMS) agencies. EMS providers completed structured, closed-response data forms for all endotracheal intubation (ETI) attempts during an 18-month period. We included all successful intubations as well as failed ETIs in which ETT securing was performed. EMS providers indicated methods used to secure the ETT, including the use of adhesive tape to the face (face tape), tape wrapped around the neck (neck tape), woven twill or umbilical tape (twill tape), intravenous or oxygen tubing (tubing), commercial tube holders, and manual stabilization/none. Providers also indicated the concurrent use of a cervical collar and/or cervical immobilization device (CID) with backboard. ETT dislodgment was reported by providers. We evaluated the rates and odds of ETT dislodgment for each tube-securing technique using multivariate logistic regression. Of 1,732 patients undergoing tube-securing efforts, ETT dislodgment occurred in 51 (2.9%). ETT dislodgment rates were as follows: tube held manually, four of 32 ...Continue Reading

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Citations

Jan 6, 2012·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·James HolmesAaron Bair
Dec 3, 2014·The Journal of Emergency Medicine·Nobuyasu KomasawaToshiaki Minami
Oct 19, 2016·Critical Care Medicine·Michael J MurraySangeeta Mehta
May 2, 2018·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Curtis DavenportJestin N Carlson
May 29, 2019·Critical Care Nursing Quarterly·Mehtap Kavurmacı, Mehtap Tan
Jan 11, 2012·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Michael S MitchellHenry E Wang

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