Taping methods and tape types for securing oral endotracheal tubes

Abstract

Purpose: To evaluate tapes and taping methods with respect to the minimum force required to dislodge endotracheal tubes (ETTs). Methods: A simulated face model consisting of a section of PVC pipe was used. The ETT was attached to a piezo-electric force transducer and pullout force was manually applied in a vertical, right or left direction. Five tape types were tested: Curity, Leukosilk, Hy.tape, Leukopore, and Transpore. Seven taping methods were used to secure the ETT. The methods differed with respect to tape width and whether the tape was split along its longitudinal axis. Each taping condition was replicated 20 times (7 methods x 5 tapes x 3 directions) for a total of 2100 pullout tests. Results; Minimum forces to dislodge ETTs were higher (P <0.05) with Curity tape (mean ± SD: 135 ± 75 N) than with the other tapes (Leukosilk: 93 ± 51 N, Hy.tape: 78 ± 34 N, Leukopore: 47 ± 32, and Transpore: 37 ± 23 N). The most secure taping method was achieved by taping the ETT, using 2.5 cm wide Curity tape, in a circumferential fashion to both the upper and lower borders of the simulated mouth opening, and reinforcing these tapes with two strips applied longitudinally across the borders of the mouth opening (method 7). Taping methods which involved splitting the tape along its longitudinal axis resulted in lower minimal pullout forces whenever the pullout force was directed towards the side of attachment (P <0.05 vs right and vertical direction). Conclusion: There are differences in ETT pullout forces and mechanisms of dislodgement depending on taping method and tape type.