Endotracheal Securement: A Guide by B&B Medical
Are you familiar with the term endotracheal securement? If not, don’t worry – you’re in the right place! In this blog post, we are going to dive deep into the world of endotracheal securement and explore why it is so crucial in medical procedures. Whether you’re a healthcare professional or simply curious about medical advancements, B&B Medical has got you covered with this comprehensive guide. Get ready to unravel the importance of endotracheal securement and discover how it can significantly improve patient outcomes. So, let’s jump right in and embark on this enlightening journey together!

Introduction to Endotracheal Securement and its Importance
Endotracheal tubes (ETT) are commonly used in critically ill patients who require mechanical ventilation. These tubes are inserted through the mouth or nose and into the trachea, allowing for oxygen delivery directly to the lungs. However, without proper securement, ETTs can become dislodged or migrate out of position, leading to serious complications such as airway obstruction, aspiration, and even death.
Endotracheal securement is the process of ensuring that the ETT remains in its intended position throughout the duration of mechanical ventilation. This involves using various devices or techniques to secure the tube in place and prevent unintentional movement.
The Importance of Endotracheal Securement
Proper endotracheal securement is crucial for patient safety and optimal outcomes. The following are some key reasons why endotracheal securement should be a top priority in clinical practice:
1. Prevents Accidental Extubation:
One of the primary purposes of endotracheal securement is to prevent accidental extubation. This occurs when an ETT becomes dislodged from its intended position due to patient movement or other factors. Accidental extubation can lead to hypoxemia (low oxygen levels), hypercapnia (high carbon dioxide levels), aspiration, and other life-threatening complications.
2. Reduces Risk of Aspiration:
When an ETT is not properly secured, it can move out of place and allow secretions or gastric contents to enter the lungs, leading to aspiration. Aspiration can cause pneumonia, acute respiratory distress syndrome (ARDS), and other serious pulmonary complications.
3. Improves Ventilation Efficiency:
Endotracheal securement helps to maintain proper tube placement, which is essential for effective ventilation. When an ETT is not secured in its intended position, it can impede proper airflow and gas exchange, resulting in inadequate oxygen delivery and ventilation.
4. Minimizes Patient Discomfort and Trauma:
Unsecured ETTs are prone to movement, which can cause irritation and discomfort for the patient. Additionally, repeated repositioning of the tube can lead to trauma of the airway tissues, increasing the risk of infection and airway injury.
5. Facilitates Oral Care:
Securely positioning an ETT allows for easier oral care for the patient. It also prevents accidental extubation during oral hygiene procedures that involve suctioning or manipulation of the tube.
The Risks of Inadequate Securement
Securing an endotracheal tube is a crucial step in the management of patients requiring mechanical ventilation. However, inadequate securement of the tube can pose serious risks and complications for the patient. In this section, we will discuss in detail the potential risks associated with inadequate securement and why it is essential to prioritize proper securing techniques.
1. Dislodgement of Endotracheal Tube:
One of the most significant risks of inadequate securement is the accidental dislodgement of the endotracheal tube. This can occur due to movement or agitation of the patient, improper positioning during transport, or even simply from coughing or sneezing. When a tube becomes dislodged, it can lead to severe consequences such as airway obstruction, hypoxemia (low oxygen levels), and respiratory distress.
2. Accidental Extubation:
Inadequate securement also increases the risk of accidental extubation where the endotracheal tube comes out unintentionally from its correct position in the trachea. This can happen when there is excessive tension on the securing device or when it becomes loose due to frequent repositioning by medical staff. Accidental extubation requires immediate intervention and reintubation which can be traumatic for both patients and healthcare providers.
3. Skin Breakdown:
Improperly secured tubes can cause friction between the skin and securing devices, leading to pressure ulcers or skin breakdowns at contact points such as around the ears or nose bridge. This can be extremely uncomfortable for the patient and may require additional interventions such as dressing changes or skin protection measures.
Different Types of Endotracheal Securement Devices
Endotracheal securement devices are essential tools used to maintain the proper placement and stability of an endotracheal tube (ETT) in patients receiving mechanical ventilation. These devices not only help prevent accidental extubation but also reduce the risk of complications such as airway trauma and pressure injuries. In this section, we will discuss the different types of endotracheal securement devices available in the market.
1. Adhesive Tape:
This is considered as one of the most commonly used methods for securing an ETT. The tape is wrapped around the patient’s face or neck, holding the tube in place. While adhesive tape is inexpensive and readily available, it may cause skin irritation and increase the risk of pressure injuries if not applied correctly.
2. Tube Holders:
These are specialized devices designed to hold an ETT securely in place without causing any damage to the patient’s skin or soft tissues. They come in various sizes and shapes, with some models featuring adjustable straps for a more customized fit. Tube holders are usually made from hypoallergenic materials such as silicone or foam, making them suitable for patients with sensitive skin.
3. Endotracheal Tube Fastener:
This type of securement device resembles a small clamp that attaches to both sides of an ETT cuff close to its proximal tip. It works by grasping onto the trachea wall when inflated, preventing any movement or displacement of the tube during ventilation.
4. Trach Collar:
Also known as a tracheostomy collar, this is a strap that wraps around the patient’s neck and secures the ETT in place. It features a foam pad that sits underneath the chin to prevent any pressure injuries. Trach collars are specifically designed for patients who require long-term ventilation through a tracheostomy tube.
5. Suture Ties:
These are sterile threads that are tied around the ETT and secured to the patient’s skin using sutures or adhesive strips. While suture ties provide excellent stability, they can be time-consuming to apply and may increase the risk of infection if not done correctly.
6. Dressing Retention Tape:
This type of tape is used in combination with other securement methods such as suture ties or tube holders. It helps keep all components of the securement system in place by providing additional support and minimizing movement.
Factors to Consider When Choosing an Endotracheal Securement Device
When it comes to choosing an endotracheal securement device, there are several important factors to consider. This decision should not be taken lightly, as the right securement device can play a critical role in patient safety and comfort during intubation.
1. Adhesive Strength:
One of the primary functions of an endotracheal securement device is to keep the breathing tube securely in place. As such, adhesive strength is a crucial factor to consider. Look for devices with strong adhesives that can withstand movement and potential stress on the tube without coming loose.
2. Skin Tolerance:
The adhesive used in some endotracheal securement devices may cause skin irritation or even allergic reactions in some patients. It is essential to choose a device that has been tested for skin tolerance and does not contain any known irritants.
3. Comfort and Flexibility:
Patients who require intubation are often already in a vulnerable state, so it’s crucial to choose a securement device that prioritizes their comfort and well-being. Look for devices made from soft, flexible materials that will not cause unnecessary pressure or discomfort on the patient’s skin.
4. Secure Placement:
Endotracheal tubes must be positioned correctly within the trachea to ensure proper ventilation and oxygenation of the patient’s lungs. The chosen securement device should provide stability, preventing any accidental movement or displacement of the tube during procedures or transport.
Proper Application and Maintenance of Endotracheal Securement Devices
Proper application and maintenance of endotracheal securement devices plays a crucial role in ensuring the safe and effective use of these medical devices. Without proper application and maintenance, endotracheal tubes can become dislodged or cause discomfort for patients, leading to potential complications and adverse events. In this section, we will discuss the steps to properly apply and maintain endotracheal securement devices.
Application:
1. Select the appropriate size:
It is important to select an endotracheal securement device that fits the specific size of your patient’s endotracheal tube. Using an improperly sized device can lead to slippage or movement of the tube, which can compromise its effectiveness.
2. Prepare the skin:
Before applying the securement device, clean and dry the area where it will be placed. This will ensure proper adhesion and prevent any irritation or infection.
3. Positioning:
Proper positioning of the securement device is critical for its effectiveness. The most common placement is just above the upper lip on one side of the face, with the other side secured on either cheek or temple area.
4. Apply gentle pressure:
After positioning, gently press down on all parts of the adhesive base to ensure good contact between it and your patient’s skin.
5. Secure tube in place:
Once you have applied gentle pressure on all parts of the adhesive base, carefully insert your patient’s tube into their airway according to standard practice guidelines.
Maintenance:
1. Regularly assess the securement device:
It is important to regularly assess the securement device for any signs of slippage, movement, or skin irritation. If these issues are present, the device may need to be repositioned or replaced.
2. Keep the area clean and dry:
To prevent infection or skin irritation, make sure to keep the area around the securement device clean and dry. Gently clean any excess moisture or debris with a soft cloth.
3. Replace as needed:
The securement device should be replaced if it becomes soiled, loose, or after a certain amount of time as recommended by the manufacturer.
4. Monitor patient comfort:
Patients may experience discomfort from the securement device due to skin irritation or pressure on their face. It is important to monitor their comfort level and make adjustments as needed.
5. Document maintenance:
Proper documentation of endotracheal tube securement device maintenance is essential for monitoring its effectiveness and ensuring patient safety.
How B&B Medical Can Help Improve End
At B&B Medical, we understand the importance of maintaining secure and stable endotracheal tubes (ETT) in critically ill patients. Our team of experts has extensive experience in the field of endotracheal securement and is dedicated to providing high-quality products and services that can help improve this crucial aspect of patient care.
One way B&B Medical can help improve endotracheal securement is by offering a variety of securement devices designed specifically for ETTs. These devices are made with soft, comfortable materials that minimize skin irritation and pressure points, while still providing strong adhesion to keep the tube securely in place. This not only ensures patient comfort but also reduces the risk of accidental extubation or displacement, which can be life-threatening for critically ill patients.
Additionally, our securement devices are easy to apply and adjust, making them ideal for use in emergency situations where rapid intubation is necessary. They are also suitable for long-term use as they can withstand movement and coughing without compromising their adhesive strength. This means healthcare providers can have peace of mind knowing that their patients’ ETTs will remain stable throughout their treatment.
Another way B&B Medical can help improve endotracheal securement is through our comprehensive training programs. We believe that proper education and training are essential for healthcare providers to effectively manage ETTs and prevent complications related to poor securement practices. That’s why we offer educational resources such as instructional videos, webinars, and on-site training to help healthcare providers learn how to properly apply and maintain our securement devices.
Conclusion
In conclusion, endotracheal securement is a crucial aspect of patient care in any medical setting. It not only ensures the safety and comfort of the patient but also plays a significant role in preventing complications and improving outcomes. As outlined in this guide by B&B Medical, proper endotracheal securement techniques and products are essential for healthcare professionals to master. By implementing these tips and utilizing high-quality securement devices, we can provide better care for our patients and improve overall healthcare practices. Let’s continue to prioritize endotracheal securement as an integral part of patient care.