Extubation force: tape versus endotracheal tube holders

Ann Emerg Med. 2007 Dec;50(6):686-91. doi: 10.1016/j.annemergmed.2007.05.013. Epub 2007 Jun 27.


Study objective: Tape is the standard method for securing endotracheal tubes to prevent extubation. This study examines the force required to extubate endotracheal tubes from cadavers with either tape or one of 4 commercially available endotracheal tube holders.

Methods: Newly deceased, unembalmed cadavers were intubated with standard tracheal intubation techniques. The endotracheal tube was secured with either tape or one of 4 commercially available endotracheal tube holders. The endotracheal tube was then connected to a force-measuring device and pulled until the cuff was removed from the trachea. The largest force recorded on the device was then marked as the "extubation force" for that trial.

Results: When tape was used to secure the endotracheal tube, it required a significantly larger force to extubate than 3 of 4 off-the-shelf endotracheal tube holders. Only the Thomas Tube Holder secured the endotracheal tube better than tape.

Conclusion: Although the Thomas Tube Holder had the greatest holding force in this study, tape was shown to be the least expensive and outperformed 3 other commercially available devices used to secure endotracheal tubes.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Cadaver
  • Device Removal / instrumentation*
  • Device Removal / methods
  • Equipment Design
  • Humans
  • Intubation, Intratracheal / instrumentation*
  • Intubation, Intratracheal / methods
  • Surgical Tape