Extubation force: A comparison of adhesive tape, non-adhesive tape and a commercial endotracheal tube holder

Study objective: This study compares adhesive tape, non-adhesive tape and a commercial endotracheal tube holder in terms of the force required to extubate endotracheal tubes from a cadaver. Methods: A newly deceased, unembalmed cadaver was orotracheally intubated. Senior paramedic students secured the endotracheal tube using adhesive tape applied using the Lillehei method, non-adhesive tape and the Thomas Tube Holder™ in a random order. The time taken to secure the endotracheal tube and the force required to remove the distal tip of the endotracheal tube from the glottis were recorded. Results: Use of adhesive tape using the Lillehei method resulted in greatest resistance to tube dislodgement, although it took significantly longer to apply than the other two methods. Conclusion: Although the Lillehei method provided the greatest resistance to tube dislodgement, it may not be ideal for the prehospital or emergency department context. The Thomas Tube Holder™ was quick and effective and may provide a good compromise in these environments, although once time is no longer important, clinicians may elect to revert to the Lillehei method which provides greater security. © 2009 Elsevier Ireland Ltd. All rights reserved.