Background: Adhesive tape is the standard method for securing tracheal tubes. There have been several studies about extubation forces in adult models. However, there have been few in pediatric models. Therefore, we examined the force required to extubate tracheal tube from a manikin using three methods.
Methods: A baby simulation manikin was orally intubated. The tracheal tube (3.0 to 4.5 mm internal diameter) was fixed at the right oral corner. The tracheal tube was secured with adhesive tape with three different methods as follows: 1) 0.63 cm-wide tape coiled around the tube twice, 2) 1.25 cm-wide tape coiled around the tube twice, 3) 1.25 cm-wide tape coiled up three times around the tube ("puttee style"). Adhesive tape was attached 10 cm on both sides of the tube along the lips. The tracheal tube was connected to a force-measuring device and pulled vertically until the tube was displaced 1 cm distally from the initial position. The required force was defined as the "extubation force". Each method was repeated 5 times.
Results: The extubation force was larger when the tape used was wider, and the contact area between the tracheal tube and tape was larger. The force was also larger as the tube diameter became larger.
Conclusions: To fix a tracheal tube securely, adhesive tape should be wider and the contact area between the tube and the tape should be larger. In this regard, "puttee style" fixation seems to be effective.