Suttapanit Karn, Yuksen Chaiyaporn, Aramvanitch Kasamon, Meemongkol Thitapohn, Chandech Arnon, Songkathee Benjamat, Nuanprom Promphet
Department of Emergency Medicine, Mahidol University, Bangkok, Thailand.
Turk J Emerg Med. 2020 Oct 7;20(4):175-179. doi: 10.4103/2452-2473.297470. eCollection 2020 Oct-Dec.
Endotracheal tube (ETT) displacement occurs by improper fixation. To fix an ETT, many types of fixation tools are employed. Thomas tube holder is one of the fixation tools widely used in many countries. This study aims to compare the ETT fixation using the Thomas tube holder with the conventional method (adhesive tape) in a mannequin model.
The fixation tools were random, using the box of six randomizes to Thomas tube holder and conventional method. After fixation, the mannequin model was being logged roll, chest compression by automated chest compression machine, and transported by the paramedic. The time to ETT fixation and displacements were recorded.
The mean time (standard deviation) to fixate an ETT was shorter (33.0 s [7.3]) with a Thomas tube holder compared to adhesive tape (52.6 s [7.3], < 0.001). The number and proportion of the ETT displacements were significantly less with Thomas tube holder compared to adhesive tape during log roll (16, 35.6% vs. 29, 64.4%, = 0.011), chest compression with automated machine (23, 51.1% vs. 37, 82.2%, = 0.003), and transport (26, 57.8% vs. 40, 88.9%, = 0.002).
The Thomas tube holder is more effective than adhesive tape in preventing ETT displacement in a mannequin subjected to log roll, chest compressions, and transportation.
气管内导管(ETT)移位是由固定不当引起的。为固定ETT,人们使用了多种固定工具。托马斯管固定器是许多国家广泛使用的固定工具之一。本研究旨在在人体模型中比较使用托马斯管固定器与传统方法(胶带)固定ETT的效果。
固定工具采用随机分组,使用随机数字表将六个盒子随机分为托马斯管固定器组和传统方法组。固定后,对人体模型进行侧翻、用自动胸外按压机进行胸外按压,并由护理人员进行转运。记录ETT固定时间和移位情况。
与胶带(52.6秒[7.3])相比,使用托马斯管固定器固定ETT的平均时间(标准差)更短(33.0秒[7.3],P<0.001)。在侧翻过程中(16次,35.6%对29次,64.4%,P=0.011)、使用自动机器进行胸外按压时(23次,51.1%对37次,82.2%,P=0.003)以及转运过程中(26次,57.8%对40次,88.9%,P=0.002),与胶带相比,托马斯管固定器导致的ETT移位次数和比例显著更少。
在对进行侧翻、胸外按压和转运的人体模型中,托马斯管固定器在预防ETT移位方面比胶带更有效。