Q What is the best practice for securing endotracheal tubes— taping, using twill ties, or using a commercial tube holder?

A Sean G. Smith, rn, bsn, nremt-p, c-npt, fp-c, tp-c, ccrn-cmc, ccrn-k, cen, cfrn, cpen, and Tom Pietrantonio, bsrt, rrt-rcp, reply:

According to the American Heart Association guidelines, postintubation management requires that endotracheal tubes be secured by using either tape or commercial devices.1  Evidence is currently limited and has yet to confirm a single best method for securing endotracheal tubes. Commercial and noncommercial methods are used to secure endotracheal tubes. Commercial methods are manufactured devices such as the Hollister Anchor-Fast and Thomas tube holders. Noncommercial methods consist of adhesive tape and nonadhesive twill product. The best method of securing the endotracheal tube would ensure maximum airway security with minimal risk of unwanted movement and/or unplanned extubation,...

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