Endotracheal tube securement apparatus

Abstract

An endotracheal (ET) tube securement apparatus includes a frame, an ET tube fastener, and attachment pads configured for anchoring to a preauricular area of cheek of a patient. The frame has a curve shape projecting outwardly away from a mouth of the patient. The ET tube fastener is configured for coupling to a mid-portion of the frame and projecting outwardly from the frame. The ET tube fastener includes a fastener base, a channel configured for receiving an ET tube projecting from a mouth or a nose of the patient, and a securing structure configured for securing the ET tube to the ET tube fastener. The securing structure includes a first securing element, and a second securing element having a complementary structure to the first securing element and configured for removably engaging with the first securing element. The attachment pads are configured for coupling to opposite ends of the frame.

Description

[0001]ENDOTRACHEAL APPARATUS PRIORITY CLAIM This application claims the benefit of the filing date of United States Provisional Patent Application Serial No.63 / 686,955, filed August 26, 2024, for “Endotracheal Tube Securement Apparatus,” the disclosure of which is hereby incorporated herein in its entirety by this reference. TECHNICAL FIELD This disclosure relates generally to apparatus for securely holding medical device and, more particularly, to apparatus for securely holding endotracheal tubes. BACKGROUND Endotracheal intubation is a medical procedure in which a flexible endotracheal tube (ET tube) is placed through a mouth or a nose into a trachea (windpipe) to help a patient breathe. In some instances, endotracheal intubation is an emergency procedure that is performed on a patient who may be unconscious or who cannot breathe on their own. Endotracheal intubation is an essential procedure for neonates requiring resuscitation and respiratory support due to extreme prematurity or other congenital anomalies. An unplanned extubation is defined as any dislodgment or removal of the ET tube from its position within the trachea that is either not specifically intended for that time or not carried out electively. The unplanned extubation is associated with many serious morbidities, including hypoxia, hypercarbia, airway trauma, intraventricular hemorrhage, and long-term neurodevelopmental disorders (e.g., blindness, deafness, cerebral palsy). The unplanned extubation can occur in all patients. However, the tendency of unplanned extubation is concerningly high in the hospitals’ neonatal intensive care units because of several unique risk factors, such as the smaller size of the neonatal patients, the warm and humid conditions within the neonatal incubator, the high frequency of the ET tube and patient manipulation, and the increased level of agitation by neonatal patients due to a low level of sedation administrated to the neonatal patients. In a first aspect of the disclosure, an endotracheal (ET) tube securement apparatus includes a frame, an ET tube fastener, and attachment pads configured for anchoring to a preauricular area of cheek of a patient. The frame has a curve shape projecting outwardly away from a mouth or a nose of the patient. The frame includes opposite ends and a mid- portion between the opposite ends of the frame. The attachment pads are configured for coupling to the opposite end portions of the frame. The ET tube fastener is configured for coupling to the mid-portion of the frame and projecting outwardly from the frame. The ET tube fastener includes a fastener base, a channel configured for receiving the ET tube projecting from the mouth or the nose of the patient, and a securing structure configured for securing the ET tube to the ET tube fastener. The fastener base includes an upper surface and a lower surface opposite to the upper surface. The securing structure comprises a first securing element on a first side of the fastener base, and a second securing element on a second side of the fastener base opposite the first side. The first securing element has a complementary structure to the second securing element and configured for removably engaging with the second securing element. In a second aspect of the disclosure, an ET tube securement apparatus includes a frame having a curve shape projecting outwardly away from a mouth or nose of a patient, and an ET tube fastener configured for coupling to the frame and adapted for receiving and securing an ET tube. The frame includes opposite ends and a mid-portion between the opposite ends. The ET tube fastener includes a securing structure for securing the ET tube to the ET tube fastener The securing structure includes a first securing element, and a second securing element having a complementary structure to the first securing element and configured for removably engaging with the first securing element. The ET tube securement apparatus also includes attachment pads configured for coupling to the opposite ends of the frame and for anchoring to a preauricular area of cheek of the patient. The ET tube securement apparatus further includes skin adhesive pads having one side configured for coupling to the attachment pads and an opposite side configured for a removable attachment to the preauricular area of cheek of the patient. BRIEF OF THE DRAWINGS For a detailed understanding of the disclosure, reference should be made to the following detailed description, taken in conjunction with the accompanying drawings, in which like elements have generally been designated with like numerals, and wherein: FIG.1 is a perspective view of an ET tube securement apparatus according to some embodiments of the disclosure; FIG.2 is a top view of the ET tube securement apparatus of FIG.1; FIG.3 is a perspective view of a frame of the ET tube securement apparatus according to some embodiments of the disclosure; FIG.4 is a perspective view of an ET tube fastener of the ET tube securement apparatus according to some embodiments of the disclosure; FIG.5 is a perspective view of an ET tube securement apparatus according to some embodiments of the disclosure; FIGS.6 and 7 illustrate an ET tube securement apparatus according to some embodiments of the disclosure, showing the ET tube securement apparatus when in use; FIG.8 is a perspective view of an ET tube securement apparatus according to some embodiments of the disclosure; FIG.9 is a perspective view of an ET tube securement apparatus according to some embodiments of the disclosure; FIG.10 is a perspective view of an ET tube securement apparatus according to some embodiments of the disclosure; FIG.11A is a front view of a frame and attachment pads of the ET tube securement apparatus according to some embodiments of the disclosure; FIG.11B is a perspective view of the frame and the attachment pads of FIG.11A; FIG.12 is a front view of the ET tube securement apparatus of FIG.11A when installed onto the frame of FIG.11A; FIG.13 is a front view of the frame and the ET tube securement apparatus of FIG. 11A when in use; FIG.14 is a perspective view of a frame, an ET tube fastener, and attachment pads of the ET tube securement apparatus according to some embodiments of the disclosure; FIG.15 is a perspective view of an ET tube securement apparatus according to some embodiments of the disclosure including the frame, the ET tube fastener, and the attachment pads of FIG.14; FIG.16 is a perspective view of tube fastener of the ET tube securement apparatus according to some embodiments of the disclosure; FIG.17 is a perspective view of a frame of the ET tube securement apparatus according to some embodiments of the disclosure; FIG.18 is a perspective view of an auxiliary fastener configured for coupling to the ET tube securement apparatus according to some embodiments of the disclosure; FIG.19 is a perspective view of an ET tube securement apparatus including the frame of FIG.18 according to some embodiments of the disclosure coupled with the auxiliary fastener of FIG.18; and FIG.20 is a perspective view of an ET tube securement apparatus of FIG.19 with the additional tube received therewith. MODE(S) FOR CARRYING OUT THE INVENTION The illustrations presented herein are not meant to be actual views of any particular ET tube securement apparatus or components thereof but are merely the representations employed to describe illustrative embodiments. The following description provides specific details, such as shapes and sizes, in order to provide a thorough description of embodiments of the disclosure. However, a person of ordinary skill in the art would understand that the embodiments of the disclosure may be practiced without employing these specific details. The structures described below may not form a complete ET securement apparatus. Only those structures necessary to understand the embodiments of the disclosure are described in detail below. Drawings presented herein are for illustrative purposes only and are not meant to be actual views of any particular material, component, structure, device, or system. Variations from the shapes depicted in the drawings as a result, for example, of manufacturing techniques and / or tolerances, are to be expected. Thus, embodiments described herein are not to be construed as being limited to the particular shapes or regions as illustrated, but include deviations in shapes that result, for example, from manufacturing. The regions illustrated in the figures are schematic in nature, and their shapes are not intended to illustrate the precise shape of a region and do not limit the scope of the present claims. The drawings are not necessarily to scale. Additionally, elements common between figures may retain the same numerical designation. As used herein, the singular forms “an,” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. As used herein, “and / or” includes any and all combinations of one or more of the associated listed items. As used herein, the term “may” with respect to a material, structure, feature, or method act indicates that such is contemplated for use in implementation of an embodiment of the disclosure, and such term is used in preference to the more restrictive term “is” so as to avoid any implication that other compatible materials, structures, features, and methods usable in combination therewith should or must be excluded. As used herein, the term “substantially” in reference to a given parameter, property, or condition means and includes to a degree that one of ordinary skill in the art would understand that the given parameter, property, or condition is met with a degree of variance, such as within acceptable tolerances. By way of example, depending on the particular parameter, property, or condition that is substantially met, the parameter, property, or condition may be at least 90.0 percent met, at least 95.0 percent met, at least 99.0 percent met, at least 99.9 percent met, or even 100.0 percent met. As used herein, “about” or “approximately” in reference to a numerical value for a particular parameter is inclusive of the numerical value and a degree of variance from the numerical value that one of ordinary skill in the art would understand is within acceptable tolerances for the particular parameter. For example, “about” or “approximately” in reference to a numerical value may include additional numerical values within a range of from 90.0 percent to 110.0 percent of the numerical value, such as within a range of from 95.0 percent to 105.0 percent of the numerical value, within a range of from 97.5 percent to 102.5 percent of the numerical value, within a range of from 99.0 percent to 101.0 percent of the numerical value, within a range of from 99.5 percent to 100.5 percent of the numerical value, or within a range of from 99.9 percent to 100.1 percent of the numerical value. As used herein, spatially relative terms, such as “below,” “above,” “lower,” “upper,” “bottom,” “top,” “upward,” “front,” “rear,” and the like, may be used for ease of description to describe one element’s or feature’s relationship to another element(s) or feature(s) as illustrated in the figures. Unless otherwise specified, the spatially relative terms are intended to encompass different orientations of the materials in addition to the orientation depicted in the figures. For example, if materials in the figures are inverted, elements described as “below” other or features would then be oriented “above” the other elements or features. As used herein, any ordinal terms, such as “first,” “second,” etc., is used for clarity and convenience in understanding the disclosure and accompanying drawings or to distinguish one claimed construct from another, and do not connote or depend on any specific sequence, preference, time, uniqueness, or order, except where the context clearly indicates otherwise. As used herein, the term “configured” or “adapted” refers to a size, shape, orientation, and arrangement of one or more of at least one structure and at least one apparatus facilitating operation of one or more of the structure and the apparatus in a pre- determined way. As used herein, the phrase “coupled to” refers to structures operatively connected with each other. FIGS.1 and 2 illustrate an ET tube securement apparatus according to some embodiments of the disclosure. The ET tube securement apparatus 10 includes a frame 100, an ET tube fastener 200 configured for receiving an ET tube projecting from a mouth or a nose of a patient, and attachment pads 300 configured for receiving skin adhesive pads 400 and anchoring to a preauricular area of cheek of the patient. As shown in FIGS.1 through 3, the frame 100 has a curve shape projecting outwardly away from the mouth or the nose of the patient. The frame 100 includes opposite ends 110, and a mid-portion 120 between the opposite ends 110. The mid-portion 120 of the frame 100 may include a protrusion feature 122 adapted for coupling with the ET tube fastener 200. The frame 100 may be made of a curved plastic material that is configured for anchoring to the patient’s face. The plastic material may be a rigid plastic material, or alternatively the plastic material may be a flexible plastic material. In some embodiments, the frame 100 includes hinges 105 at the opposite ends 110 of the frame 100. The hinges 105 may be configured for coupling the attachment pads 300 to opposite ends 110 of the frame 100. As shown in FIGS.1, 2 and 4, the ET tube fastener 200 is configured for coupling to the mid-portion 120 of the frame 100 and projecting outwardly from the frame 100. In some embodiments, the ET tube fastener 200 is configured for a fixed coupling to the frame 100. In some embodiments, the ET tube fastener 200 is configured for a removable coupling to the frame 100. The ET tube fastener 200 includes a fastener base 205, a channel 230 (or 230′, 230″) configured an ET tube projecting from the mouth or the nose of the patient, and a securing structure 240 configured for securing the ET tube to the ET tube fastener 200. The fastener base 205 has an upper surface 270 and a bottom surface opposite to the upper surface 270. The fastener base 205 includes a rear end 210 and a front end 220. When coupled to the frame 100, the rear end 210 of the fastener base 205 is proximal to the frame 100 and a front end 220 of the fastener base 205 is distal from the frame 100. In some embodiments, the channel 230 (or 230′, 230″) extends from the rear end 210 of the fastener base 205 to the front end 220 of the fastener base 205. The securing structure 240 of the ET tube fastener 200 includes a first securing element 250 on a first side 205A of the fastener base 205, and a second securing element 260 on a second side 205B of the fastener base 205 opposite the first side 205A. The first securing element 250 has a complementary structure to the second securing element 260 and configured for removably engaging with the second securing element 260. Any known complementary fastening structures may be used for the ET tube fastener 200. In some embodiments, the first securing element 250 of the ET tube fastener 200 includes a securing knob, and the second securing element 260 includes an elastic strap. The second securing element 260 is configured for wrapping around a portion of the ET tube and reversibly hooking onto the corresponding first securing element 250, thus holding the ET tube in place with tension and frictional forces. The ET tube fastener 200 includes one or more securing structures 240. Although the figures of the disclosure show that the ET tube fastener 200 includes two securing structures 240, the disclosure is not limited and the ET tube fastener 200 may include different numbers of securing structures 240 (e.g., one, three or four securing structures 240). In some embodiments, the securing structure 240 further includes a gripping element 265 to enhance an ease of engaging and disengaging the first securing element 250 and the second securing element 260 of the ET tube fastener 200. As a non-limiting example shown in FIGS.1, 2 and 4, the gripping element 265 is connected to the second securing element 260 of the ET tube fastener 200. The gripping element 265 is adapted for pulling the second securing element 260 toward the first securing element 250 or away from the first securing element 250. In some embodiments, the first securing element 250, the second securing element 260 or both includes a textured surface for an enhanced securement of the ET tube to the ET tube fastener 200. As a non-limiting example shown in FIGS.1, 2 and 4, the second securing element 260 includes a textured to enhance the gripping of the ET tube onto the ET tube fastener 200. Referring to FIGS.1 and 2, the ET tube securement apparatus 10 also includes attachment pads 300 configured for coupling to the opposite ends 110 of the frame 100. The attachment pads 300 are configured for attaching to the left and right facial cheek zones of the patient, such as preauricular areas of the cheeks. In some embodiments, the attachment pads 300 are configured for removable coupling to the opposite ends 110 of the frame 100. Due to the removable coupling characteristics between the attachment pads 300 and the frame 100, the attachment pads 300 may be removed from the frame 100 when a replacement of the attachment pads 300 with new attachment pads 300 is needed without perturbing the ET tube. In some embodiments, the attachment pads 300 are flexible, conformable pads configured for a removable coupling to the opposite ends 110 of the frame 100 and anchoring the ET tube securement apparatus 10 to the facial cheek zones of the patient. Still referring to FIGS.1 and 2, the ET tube securement apparatus 10 may further include skin adhesive pads 400 configured for coupling to the attachment pads 300 of the ET tube securement apparatus 10 and for attaching to the facial cheek zones of the patient. Each of the skin adhesive pads 400 includes a first side 410 and a second side 420 opposite to the first side 410. The first side 410 of the skin adhesive pad 400 is configured for coupling to the attachment pads 300. The second side 420 of the skin adhesive pad 400 is configured for attaching to the facial cheek zones of the patient. In some embodiments, the first side 410 of the skin adhesive pad 400 includes a reversible mechanical coupling element (e.g., Dual Lock™ reclosure fastener) to enhance the attachment of the skin adhesive pads 400 to the attachment pad 300. In some embodiments, the skin adhesive pads 400 are configured for a removable coupling to the attachment pads 300 of the ET tube securement apparatus 10. The skin adhesive pads 400 may be removed from the attachment pads 300 when a replacement is needed and replaced with new skin adhesive pads 400. Since the skin adhesive pad 400 may be fully decoupled from the ET tube securement apparatus 10, the replacement of the skin adhesive pad 400 may be performed without perturbing the ET tube. FIG.5 illustrates the ET tube securement apparatus 10, which includes the frame 100 (FIG.3), the ET tube fastener 200 (FIG.4) configured for receiving an ET tube projecting from a mouth or a nose of a patient, and attachment pads 300 configured for receiving skin adhesive pads 400 and to a preauricular area of cheek of the patient. The hinges 105 at the opposite ends 110 of the frame 100 couple the attachment pads 300 to the opposite ends 110 of the frame 100. The hinges 105 may be configured to allow a swivel movement of the attachment pads 300 relative to the opposite ends 110 of the frame 100. The swivel movement of the attachment pads 300 may allow for a customized fit for patients having varying shapes and sizes. Furthermore, the swivel movement of the attachment pads 300 may facilitate a replacement of the skin adhesive pads 400 underneath the attachment pads 300. FIGS.6 and 7 illustrate the ET tube securement apparatus 10 when in use. The attachment pads 300 attach to the preauricular areas of cheeks 30 of the patient by the skin adhesive pads 400. The attachment pads 300 is coupled to the opposite ends 110A, 110B of the curved frame 100 that projects outwardly away from the mouth or the nose of the patient. The ET tube fastener 200 is coupled to the mid-portion 120 of the frame 100, with the front end 220 of the ET tube fastener 200 projecting outwardly from the frame 100. The channel extending along the upper surface 270 of the ET tube fastener 200 receives the ET tube 20 projecting from the mouth or the nose of the patient. The ET tube 20 is secured to the ET tube securement apparatus 10 by the securing structure 240 of the ET tube fastener 200. As shown in FIG.6, the ET tube 20 is received by the channel on the upper surface 270 of the ET tube fastener 200, while the channel on the bottom surface 280 of the ET tube fastener 200 does not contain ET tube or any other tube therein. Furthermore, as described earlier in FIG.5, the attachment pads 300 may be adapted for a swivel movement relative to the respective opposite end portions 110A, 110B of the frame 100 to allow for a customized fit for patients having varying shapes and sizes. The swivel movement of the attachment pads 300 also facilitates a replacement of the skin adhesive pads 400 underneath the attachment pads 300. FIG.8 illustrates an ET tube securement apparatus according to some embodiments of the disclosure. The ET tube securement apparatus 40 includes the frame 100 (FIG.3), an ET tube fastener 200ՙ configured for receiving an ET tube projecting from a mouth or a nose of a patient, and attachment pads 300 configured for receiving skin adhesive pads 400 and anchoring to a preauricular area of cheek of the patient. As discussed above, the hinges 105 at the opposite ends 110 of the frame 100 are configured for coupling the attachment pads 300 to the opposite ends 110 of the frame 100, and allowing the swivel movement of the attachment pads 300 relative to the opposite ends 110 of the frame 100. As shown in FIG.8, the ET tube 200ՙ of the ET tube securement apparatus 40 is configured to receive and secure more than one tube at a time. The ET tube fastener 200ՙ has channels 230Aՙ and 230Bՙ on a same upper surface of the fastener base 205ՙ, each extending from the rear end 210ՙ proximal to the frame 100 to the front end 220ՙ distal to the frame 100. FIG.8 shows that the channels 230Aՙ, 230Bՙ have the same width and position parallel to each other, but the disclosure is not limited and the two channels of the ET tube fastener may have different widths and may not position parallel to each other on the fastener base 205ՙ of the ET tube fastener 200ՙ. Further, FIG.5 depicts only one surface of fastener base 205ՙ (the upper surface). The opposite surface of the fastener base 205ՙ (the bottom surface, not shown in FIG.8) may also include one or more additional channels, similar to those illustrated on FIG.16. The ET tube fastener 200ՙ is configured for coupling to the mid-portion 120 of the frame 100 and projecting outwardly from the frame 100. The ET tube fastener 200ՙ may configured for a fixed coupling to the frame 100, or alternatively the ET tube fastener 200ՙ may be configured for a removable coupling to the frame 100. The ET tube fastener 200ՙ includes a securing structure 240′ configured for securing the ET tube to the ET tube fastener 200ՙ. The securing structure 240′ of the ET tube fastener 200′ includes a first securing element 250′ on a first side 205A′ of the fastener base 205′, and a second securing element 260′ on a second side 205B′ of the fastener base 205 opposite the first side 205A′. The first securing element 250′ has a complementary structure to the second securing element 260′ and configured for removably engaging with the second securing element 260′. Any known complementary fastening structures may be used for the ET tube fastener 200′. The second securing element 260′ is configured for wrapping around a portion of the tubes and reversibly coupling to the corresponding first securing element 250′, thus holding the tubes in place within the channels 230Aՙ, 230Bՙ with tension and frictional forces. The ET tube fastener 200ՙ is shown in FIG.8 as including two (2) securing structures 240ՙ. However, the disclosure is not limited and the ET tube fastener 200ՙ may include different numbers of securing structures 240ՙ (e.g., one, three or four securing structures 240ՙ). FIG.9 illustrates an ET tube securement apparatus according to some embodiments of the disclosure. The ET tube securement apparatus 50 includes a frame 100(1), the ET tube fastener 200ՙ (as described in FIG.8) configured for receiving an ET tube projecting from a mouth or a nose of a patient, and attachment pads 300 configured for receiving skin adhesive pads 400 and anchoring to a preauricular area of cheek of the patient. The frame 100(1) of the ET tube apparatus 50 has a curve shape projecting outwardly away from the mouth or the nose of the patient. The frame 100(1)includes opposite ends 110(1), and a mid-portion 120(1) between the opposite ends 110(1) of the frame 100(1). The frame 100(1)includes one or more living hinges 115 configured to provide a customized fit for patients having varying shapes and sizes. The living hinges 115 locate along the length of the frame 100(1)and allow for an adjustment of angle at which the frame 100(1) sits on the preauricular area of cheek of the patient. As a non- limiting example, as shown in FIG.9, the frame 100(1)includes at least one living hinge 115 disposed between the middle section 120(1) of the frame 100(1) and one of the opposing ends 110(1)of the frame 100(1). In some embodiments, the living hinges 115 are created by thinning, cutting, or removing a section of frame 100(1) to allow for bending or twisting of the frame 100(1). Each living hinge 115 acts as a pivot point, enabling the connected parts to rotate or flex relative to each other. FIG.10 illustrates an ET tube securement apparatus according to some embodiments of the disclosure. The ET tube securement apparatus 60 includes a length- adjustable frame 100(2), the ET tube fastener 200ՙ (as described in FIG.8) configured for receiving an ET tube projecting from a mouth or a nose of a patient, and attachment pads 300 configured for receiving skin adhesive pads 400 and anchoring to a preauricular area of cheek of the patient. The length-adjustable frame 100(2) of the ET tube securement apparatus 60 has a curve shape projecting outwardly away from the mouth or the nose of the patient. The length-adjustable frame 100(2) includes opposite ends 110(2), and a mid-portion 120(2) between the opposite ends 110(2). The length-adjustable frame 100(2)includes at least one slide part 127 located along a length of the length-adjustable frame 100(2) and allows for an adjustment of the length of the frame to provide a customized fit for patients having varying shapes and sizes. For a non-limiting example, as shown in FIG.10, the length- adjustable frame 100(2)includes the slide parts 127 each disposed between the mid-portion 120(2) of the length-adjustable frame 100(2) and one of the opposing ends 110(2) of the length-adjustable frame 100(2). The slide part 127 is movable with respect to the frame in a length direction of the length-adjustable frame 100(2). The mechanism of sliding the slide part 127 to adjust the length of the frame 100(2)may be similar to the mechanism of sliding a slidable part of a headphone to adjust the length of the headphone to enhance a customized fit for user. When in use, the caretaker may length of the frame by sliding the slide part 127 with respect to the length-adjustable frame 100(2)in a length direction of the frame so that a secured and comfortable fit between the ET tube securement apparatus 60 and the patient may be achieved. FIGS.11A and 11B show the front view and the perspective view, respectively, of the frame 100(3)and the pad attachment pads 300(3)according to some embodiments of the disclosure. The frame 100(3) and the pad attachment pads 300(3) utilize a “key design protrusion hole” concept, which involves a keyhole designed to accommodate a protruding key feature. The frame 100(3)has a curve shape projecting outwardly away from the mouth or the nose of the patient. The frame 100(3) includes opposite ends 110(3), and a mid-portion 120(3)between the opposite ends 110(3). The frame 100(3)includes a protrusion feature 122(3) configured for coupling with the ET tube fastener of the ET tube securement apparatus. The frame 100(3)also includes protruding key features 125 at opposite ends 110(3) of the frame 100(3). The pad attachment pads 300(3) individually include a keyhole 325 adjacent to one end thereof. The keyhole 325 has a complementary size and shape to the protruding key feature 125 at each opposite end 110(3) of the frame 100(3). The protruding key feature 125 of the frame 100(3)is designed with a specific shape and size to fit within the keyhole 325 of the pad attachment pads 300(3) in a certain orientation, thus the pad attachment pads 300(3)may be installed onto or removed from the frame 100(3)in only certain orientation. The “key design protrusion hole” concept of the protruding key feature 125 and the keyhole 325 provide a secure coupling between the pad attachment pads 300(3)and the frame 100(3), while allowing for a swivel movement of the pad attachment pads 300(3) relative to the opposite ends 110(3)of the frame 100(3). FIG.12 illustrates an ET tube securement apparatus according to some embodiments of the disclosure. The ET tube securement apparatus 70 includes the frame 100(3) (as described in FIG.11A), an ET tube fastener (not shown) configured for receiving an ET tube projecting from a mouth or a nose of a patient, and attachment pads 300(3)(as described in FIG.11A) configured for receiving skin adhesive pads (not shown) and anchoring to a preauricular area of cheek of the patient. FIG.12 shows an installation of the pad attachment pads 300(3) of FIG.11A onto the frame 100(3) of FIG.11A. The keyholes 325 of the pad attachment pads 300(3) are engaged with the protruding key features 125 of the frame 100(3) in only one orientation, when the protruding key features 125 are lined up with the keyholes 325. In FIG.13, after the pad attachment pads 300(3) of FIG.11A are coupled to the frame 100(3)of FIG.11A, the pad attachment pads 300(3)may be rotated in a swivel moment for an adjustable fit onto a preauricular area of cheek of the patient while securely coupled to the frame 100(3). The “key design protrusion hole” concept of the protruding key feature 125 of the frame 100(3)and the keyhole 325 of the pad attachment pads 300(3)may enhance an ease of replacing the pad attachment pads 300(3) without perturbing of the ET tube lodged in the trachea of the patient. The pad attachment pads 300(3)may be removed from the frame 100(3) by simply rotating the pad attachment pads 300(3) until the protruding key features 125 of the frame 100(3)are lined up with the keyholes 325 of the pad attachment pads 300(3) and pulling the pad attachment pads 300(3) away from the frame 100(3). FIG.14 shows a front view of a frame 100(4), an ET tube fastener 200(4)coupled to the frame 100(4), and pad attachment pads 300(4) according to some embodiments of the disclosure. The frame 100(4)has a curve shape projecting outwardly away from the mouth or the nose of the patient. The frame 100(4) includes opposite ends 110(4), and a mid-portion 120(4)between the opposite ends 110(4)of the frame 100(4). The mid-portion 120(4)of the frame 100(4) includes a protrusion feature 122(4) configured for coupling with the ET tube fastener 200(4). The frame 100(4)includes a hook feature 128 at each opposite end 110(4)of the frame 100(4). The hook feature 128 is configured for coupling the attachment pad 300(4) to each opposite end 110(4)of the frame 100(4). The pad attachment pad 300(4) includes an opening 328 adjacent to one end and an optional raised bumper (e.g., protrusion, knob) 330 adjacent to an opposite end. The opening 328 of the pad attachment pad 300(4) is configured for allowing the slide movement of the opening 328 through the track of the hook feature 128 of the frame 100(4)toward the 100(4), thus securing the pad attachment pad 300(4) to the frame 100(4). The optional raised bumper 330 may be configured to increase an ease of displacing the pad attachment pad 300(4) from the preauricular area of cheek of the patient. The ET tube fastener 200(4)is configured for coupling to the protrusion feature 122(4) at the mid-portion 120(4) of the frame 100(4) and projecting outwardly from the frame 100(4). The ET tube fastener 200(4) may be configured for a fixed coupling to the frame 100(4), or alternatively the ET tube 200(4) may be configured for a removable coupling to the frame 100(4). The ET tube fastener 200(4)includes a fastener base 205(4), a channel 230(4) configured for receiving an ET tube projecting from the mouth or the nose of the patient, and a securing structure 240(4)configured for securing the ET tube to the ET tube fastener 200(4). The fastener base 205(4) includes a first securing element 250(4) on a first side 205A(4)of the fastener base 205(4), and a second securing element 260(4)on a second side 205B(4) of the fastener base 205(4) opposite the first side 205A(4). The first securing element 250(4)has a complementary structure to the second securing element 260(4) and configured for removably engaging with the second securing element 260(4). Any known complementary fastening structures may be used for the ET tube fastener 200(4). As a non-limiting example, as shown in FIG.14, the first securing element 250(4) of the ET tube fastener 200(4)includes a securing knob, and the second securing element 260(4) includes an elastic strap. The second securing element 260(4) is configured for wrapping around a portion of the ET tube and reversibly hooking onto the corresponding first securing element 250(4), thus holding the ET tube in place with tension and frictional forces. FIG.15 illustrates an ET tube securement apparatus according to some embodiments of the disclosure. The ET tube securement apparatus 80 includes the frame 100(4), the ET tube fastener 200(4), and the pad attachment pads 300(4)shown in FIG.14. The pad attachment pad 300(4) may be installed onto the frame 100(4) by sliding the opening 328 of the pad attachment pads 300(4)through the track of the hook feature 128 of the frame 100(4) toward the 100(4), thus securing the pad attachment pad 300(4) to the frame 100(4). The opening 328 is adjacent to the end of the pad attachment pad 300(4)proximal to the frame, while the optional raised bumper (e.g., protrusion, knob) 330 is adjacent to the opposite end of the pad attachment pad 300(4)distal to the frame 100(4). The interface between the hook feature 128 of the frame 100(4) and the opening 328 of the pad attachment pad 300(4)may allow a swivel moment of the pad attachment pad 300(4)for an adjustable fit onto a preauricular area of cheek of the patient while securely coupled to the frame 100(4). The interface between the hook feature 128 and the opening 328 may enhance the ease of replacing the pad attachment pads 300(4)without perturbing of the ET tube lodged in the trachea of the patient. To replace the pad attachment pads 300(4) while the ET tube securement apparatus 80 is in use, the pad attachment pads 300(4) may be removed from the frame 100(4) by sliding the opening 328 pad attachment pads 300(4) through the track of the hook feature 128 of the frame 100(4)away from the frame 100(4)until the pad attachment pads 300(4) are separated from the frame 100(4). Thereafter, new pad attachment pads 300(4)may be installed onto the frame 100(4)by sliding the opening 328 of the new pad attachment pads 300(4) through the track of the hook feature 128 of the frame 100(4) toward the 100(4), thus securing the new pad attachment pad 300(4)to the frame 100(4). Furthermore, the optional raised bumper 330 adjacent to the opposite end of the pad attachment pad 300(4)may be lifted from the preauricular area of cheek of the patient prior to sliding the opening 328 away from the frame 100(4) to further enhance the ease of removing the old pad attachment pads 300(4)from the frame 100(4)and replacing with the new pad attachment pads 300(4). The conventional method for securing the ET tube to patient utilizes adhesive tape, either through attaching the ET tube to the patient directly or through using a conventional ET tube securement apparatus. However, there are many drawbacks to use adhesive tape for such purpose. For example, tape adhesive suffers poor adhesion performance when used for securing the ET tube to the neonatal patients. The neonatal incubators are maintained at a temperature of about 37°C and a relative humidity level of more than 80%. Therefore, it is quite warm and humid insider the neonatal incubators. Preterm neonatal patients are often placed in the incubator for 30 or more days. In addition, neonatal patients (especially preterm neonates) produce significant moisture through partially formed skin and around the mouth. These environmental conditions inevitably deteriorate the adhesion performance of the adhesive tape in securing the ET tube. Also intubated neonatal patients often vomit, causing the adhesive tape to become in contact with the vomit and further worsen the adhesion performance of the adhesive tape. As a result, an unintentional dislodgment or movement of the ET tube from its proper position within the patient’s trachea is concerningly high in the hospitals’ neonatal intensive care units. Furthermore, using an adhesive tape for securement requires more than one medical professional to adjust the position of the ET tube within the patient’s trachea and to secure adhesive tape between the ET tube securement apparatus and the ET tube, thereby adding time and demanding more work from the medical professionals. Moreover, using an adhesive tape for securement is not easily reversible. The ET Tube securement apparatus of present disclosure does not utilize adhesive tape and therefore is not affected by humidity, including the high humidity level in the neonatal incubator. Furthermore, the ET Tube securement apparatus utilizes the fastener system that may be easily and quickly adjusted, engaged and disengaged. The disclosed ET Tube securement apparatus may allow for a single medical professional to make an adjustment to the position of the ET tube within the trachea of the patient. The securement of ET tube to neonatal patients is more difficult and challenging to achieve compared to the securement of ET tube to adult patients. In addition to the warm and humid environments in the neonatal incubator, the small size of neonatal patient renders the proper securement of ET tube to the patients rather complicated. The precision of placing the ET tube at a proper position within the trachea of the patient is more critical for neonatal patients since neonatal patients have short tracheal lengths. Therefore, the margin of error for a proper position of the ET tube within the patient’s trachea is miniscule. For adult patients, the margin of error for a proper position of the ET tube can be up to ±4 centimeters (cm). For neonatal patients, the margin of error for a proper position of the ET tube is less than ±1 cm. With the conventional ET tube securement apparatus, for neonatal patients the medical professional has to estimate the relative depth of the ET tube within the neonatal patient’s trachea or place a measuring tape against the lip of the patient for measuring and adjusting the depth of ET tube within the neonatal patient’s trachea. FIG.16 shows the ET tube fastener 200(1)according to some embodiments of the disclosed ET tube securement apparatus. The ET tube fastener 200(1) includes a fastener base 205(1), at least one channels 230′(1)configured for receiving an ET tube projecting from the mouth or the nose of the patient, and securing structures 240(1) configured for securing the ET tube to the ET tube fastener 200(1). The fastener base 205(1) of the ET tube fastener 200(1) includes a series of markings 290 on its surface adjacent to the channel 230′(1), which extends along the fastener base 205(1). The series of markings 290 assist the medical professional in placing and / or adjusting the ET tube to a proper position within the trachea of the patient. The series of markings 290 indicate the relative depth of the ET tube within the trachea of the patient, thereby facilitating the adjustment or repositioning of the ET tube in the trachea of the patient. In some embodiments, the series of markings 290 on the fastener base 205(1) of the ET tube fastener 200(1)are provided for a series of incremental length of less than 1 cm. In some embodiments, the series of markings 290 are provided for every 0.75 cm of the relative depth. In some embodiments, the series of markings 290 are provided for every 0.50 cm of the relative depth. In some the series of markings 290 are provided for every 0.25 cm of the relative depth. In some embodiments, the series of markings 290 are provided for every 0.2 cm of the relative depth. In some embodiments, the series of markings 290 on the disclosed ET tube securement apparatus 10 are provided for every 0.1 cm of the relative depth. The series of markings 290 on the surface of the fastener base 205(1)of the ET tube fastener 200(1) assist the medical professional in placing and / or adjusting the ET tube to a proper position within the trachea of the patient, especially the neonatal patient. These markings 290 not only increase the precision in placing the ET tube within the trachea of the patient, but also reduce the time required for the medical professional to achieve a proper placement of the ET tube within the trachea of the patient, especially during the urgent care situation. The securing structure 240(1) of the ET tube fastener 200(1) includes a first securing element 250(1)on one side 205A(1)of the fastener base 205(1), and a second securing element 260(1) on a opposite side 205B(1) of the fastener base 205(1). The first securing element 250(1) has a complementary structure to the second securing element 260(1) and configured for removably engaging with the second securing element 260(1). Any known complementary fastening structures may be used for the ET tube fastener 200(1). In some embodiments, as shown in FIG.16, the first securing element 250(1)of the ET tube fastener 200(1) includes a securing knob, and the second securing element 260(1) includes an elastic strap. The second securing element 260(1)is configured for wrapping around a portion of the ET tube and reversibly hooking onto the corresponding first securing element 250(1), thus holding the ET tube in place with tension and frictional forces. The ET tube fastener 200(1) is shown as including two one securing structures 240(1). However, the disclosure is not limited and the ET tube fastener 200(1)may include different numbers of securing structures 240(1) (e.g., one, three or four securing structures 240(1)). In some embodiments, the ET tube securement apparatus may allow for multiple tubes to be secured thereon at a time, and further allow one of the tubes (e.g., ET tube) to be selectively removed or adjusted while the other tube (e.g., another ET tube, additional tube) remains secured, i.e., held in place longitudinally to control the depth of the other tube in the patient. Each of the tubes may have same or different diameters compared to each other. Non-limiting examples of the additional tube are a nasogastric tube or an orogastric tube. As shown in FIG.16, in some the ET tube fastener 200(1) is configured to receive and secure more than one tubes at a time. The ET tube fastener 200(1)has a channel 230(1)′ on the upper surface 270(1) of the fastener base 205(1). The ET tube fastener 200(1)also has a channel 230(1)″ on the bottom surface 280(1)of the fastener base 205(1). Therefore, the ET tube fastener 200(1) may receive one tube (e.g., ET tube) in the channel 230(1)′ on the upper surface 270(1)of the fastener base 205(1)and another tube (e.g., another ET tube, additional tube) in the channel 230(1)″ on the bottom surface 280(1) of the fastener base 205(1). Each of the tubes may be secured by the securing structures 240(1) of the ET tube fastener 200(1). In some embodiments, the channel 230(1)′ on one surface of the fastener base 205(1)has the same width as the channel 230(1)″ on the opposite surface of the fastener base 205(1). In some embodiments, the channel 230(1)′ has a different width than the channel 230(1)″. As a non-limiting example shown in FIG.16, the channels 230(1)′, 230(1)″ of the ET tube fastener 200(1) have different widths and thereby allowing the ET tube fastener 200(1)to receive the tubes of different diameter sizes. As a non-linting example, FIG.16 illustrates that the channel 230(1)′ on the upper surface 270(1) of the ET tube fastener 200(1) has a larger width than the opposite channel 230(1)″ on the lower surface 280(1)of the ET tube fastener 200(1). The ET tube fastener 200(1)may be configured for a fixed coupling to the frame of the ET tube securement apparatus, or alternatively the ET tube fastener 200(1)may be configured for a removable coupling to the frame of the ET tube securement apparatus. In some embodiments, wherein the ET tube fastener 200(1)of FIG.16 is used in the ET tube securement apparatus and another tube of different diameter size (e.g., another tube having a larger diameter) is to be secured also by the ET tube securement apparatus, a medical professional may flip an entire ET securement apparatus 180 degrees, so that the channel 230(1)″ on the bottom surface 280(1)of the ET tube fastener 200(1)with an appropriate width (e.g., the channel having larger width) may be utilized to receive the another tube. FIGS.17 through 20 show some further embodiments of the ET tube securement apparatus that is configured to receive and secure more than one tubes at a time. One of the tubes (e.g., ET tube) may be secured by the ET tube securement apparatus, while another one of the tubes (e.g., another ET tube, additional tube) may be secured by an auxiliary fastener removably coupled to the ET tube securement apparatus. For ease of illustration and description, the ET tube fastener, the attachment pads, and the skin adhesive pads are omitted in FIGS.17 through 20. It is to that any embodiments of the ET tube fastener, the attachment pads, and the skin adhesive pads described earlier in some other embodiments may be used in the instant embodiments. FIG.17 illustrates the frame 100′ according to some embodiments of the ET tube securement apparatus. The frame 100′ includes opposite ends 110′, a mid-portion 120′ between the opposite ends 110′, and an auxiliary attaching feature 130′ configured for receiving and securing an additional tube. The opposite ends 110′ of the frame 100′ are adapted for coupling with the attachment pads, which are configured for attachment to the skin adhesive pads. The mid-portion 120′ of the frame 100′ are configured for attachment to the ET tube fastener of the ET securement apparatus. The frame 100′ has a curve shape projecting outwardly away from a mouth or a nose of the patient. The mid-portion 120′ of the frame 100′ has a rear end 120′R proximal to the mouth or the nose of the patient when the ET tube securement apparatus is in use, and a front end 120′F distal to the mouth or the nose of the patient when the ET tube securement apparatus is in use. The mid-portion 120′ includes opposite end regions 124′, a central region 123′ between the opposite end regions 124′, and a protrusion region 122′ projecting outwardly from the central region 123′. The protrusion region 122′ is configured for coupling to the ET tube fastener. In some embodiments, as shown in FIG.17, the auxiliary attaching feature 130′ includes support straps 140′ disposed between the mid-portion 120′ of the frame 100′ and the opposite ends 110′ of the frame 100′. The support straps 140′ connect the opposite end regions 124′ of the mid-portion 120′ of the frame 100′ to the opposite end portions 110′ of the frame 100′. The support straps 140′ include a front portion 140′F and a rear portion 140′R spaced from the front portion 140′F by a gap 150′. The front portion 140′F of the support straps 140′ connects the front end 120′F of mid-portion 100′ to the corresponding opposite end portion 110′ of the frame 100′, while the rear portion 140′R of the support straps 140′ connects the rear end 120′R of mid-portion 120′ to the same corresponding opposite end portion 110′ of the frame 100′. FIG.18 shows an auxiliary clip according to some embodiments of the disclosure adapted for coupling with the auxiliary attaching feature (e.g., 130’ of FIG.17) of the frame (e.g., 100’ of FIG.17) of the ET tube securement apparatus (e.g., 10’ of FIG.20) to receive and secure the additional tube (e.g., 90 of FIG.20). The auxiliary clip 500 includes an auxiliary base 530 having a rear surface 510 and a front surface 520, and an auxiliary securing structure 540 on the front surface 520 of the auxiliary base 530. The auxiliary securing structure 540 includes a 550 and an elastic strap 560 adapted for wrapping over a portion of the additional tube and reversibly hooking onto the securing knob 550, thus securing the additional tube to the frame of the disclosed ET securement apparatus. In some embodiments, the auxiliary clip 500 further includes a positioning grip 565 for enhancing an ease of engaging and disengaging the securing knob 550 and the elastic strap 560 of the auxiliary securing structure 540. As a non-limiting example shown in FIG.18, the positioning grip 565 is connected to the elastic strap 560 of the auxiliary securing structure 540. The positioning grip 565 is adapted for pulling the elastic strap 560 toward the securing knob 550 or away from the securing knob 550. FIGS.19 and 20 show the ET tube securement apparatus according to some embodiments of the disclosure. The ET tube securement apparatus 10′ includes the auxiliary clip 500 of FIG.18 coupling to one of the support straps 140ʹF of the auxiliary attaching feature 130′ of the frame 100′ of FIG.17. The securing knob 550 of the auxiliary securing structure 540 and portions of the auxiliary base 530 are inserted upward through the gap 150′ between the front portion 140′F and the rear portion 140′R of the support straps 140′ of the auxiliary attaching feature 130′ of the frame 100′, resulting in the securing knob 550 positioning above the front portion 140′F of the support straps 140′ while the elastic strap 560 and the optional positioning grip 565 positioning below the front portion 140′F of the support straps 140′. In FIG.20, the additional tube 90 is received on the elastic strap 560 of the auxiliary securing structure 540. In order to secure the additional tube 90 to the auxiliary clip 500 coupling to the auxiliary attaching feature 130′ (e.g., one of the support straps 140F′) of the frame 100′, the elastic strap 560 is pulled upward (e.g., via an optional positioning grip 565) to wrap around a portion of the additional tube 90 and reversibly hook onto the securing knob 550, thereby holding the additional tube 90 in place with tension and frictional forces. The ET tube securement apparatus of the present disclosure presents many benefits and address drawbacks of conventional ET tube securement apparatus. The disclosed ET tube securement apparatus does not utilize adhesive tape and therefore may not be affected by humidity (e.g., a warm and humid conditions inside the neonatal incubator), vomit, or other application conditions that negatively impact the adhesion performance of adhesive tape. The disclosed ET tube securement utilizes the fastener system that may facilitate a quick engagement and disengagement of the ET tube secure therewith. The disclosed ET tube securement apparatus may provide an ease and convenience in adjusting the ET tube within the trachea of the patient, and for a single medical professional to achieve such task. The disclosed ET tube securement apparatus may be provided with a series of markings extending along the fastener base of the ET tube fastener to indicate the relative depth of the ET tube within the trachea of the patient at an increment length of less than 1 cm, thus increasing the precision of placing the ET tube at a proper position within the patient’s trachea especially for the neonatal patients. Further, the disclosed ET tube securement apparatus may allow for multiple tubes to be secured thereon at a time and may further allow one of the tubes (e.g., ET tube) to be selectively removed or adjusted while the other tube (e.g., another ET tube, additional tube) being held in place longitudinally to control the depth of the other tube. The embodiments of the disclosure described above and illustrated in the accompanying drawings do not limit the scope of the disclosure, which is encompassed by the scope of the appended claims and their legal equivalents. Any equivalent embodiments are within the scope of this disclosure. Indeed, various modifications of the disclosure, in addition to those shown and described herein, such as alternate useful combinations of the elements described, will become apparent to those skilled in the art from the description. Such modifications and embodiments also fall within the scope of the appended claims and equivalents.

Claims

What is claimed is:

1. An endotracheal tube securement apparatus, comprising: a frame having a curve shape projecting outwardly away from a mouth or a nose of a patient, the frame including opposite ends and a mid-portion between the opposite ends; an endotracheal (ET) tube fastener configured for coupling to the mid-portion of the frame and projecting outwardly from the frame, the ET tube fastener including: a fastener base including an upper surface and a lower surface opposite to the upper surface; a channel configured for receiving an ET tube projecting from the mouth or the nose of the patient; and a securing structure configured for securing the ET tube to the ET tube fastener, the securing structure including: a first securing element on a first side of the fastener base; and a second securing element on a second side of the fastener base opposite to the first side, the second securing element having a complementary structure to the first securing element and configured for removably engaging with the first securing element; and attachment pads configured for coupling to the opposite ends of the frame and for anchoring to a preauricular area of cheek of the patient.

2. The apparatus of claim 1, wherein: the first securing element of the ET tube fastener comprises a securing knob; and the second securing element of the ET Tube fastener comprises an elastic strap adapted for wrapping around a portion of the ET tube and reversibly hooking onto the securing knob.

3. The apparatus of claim 1 or 2, further comprising skin adhesive pads configured for coupling to the attachment pads and for attachment to the preauricular area of cheek of the patient.

4. The apparatus of any one of claims 1 through 3, wherein the ET tube fastener further includes an additional channel configured for receiving an additional tube.

5. The apparatus of claim 4, wherein the channel and the additional channel are on the upper surface of the fastener base.

6. The apparatus of claim 4, wherein the channel is on the upper surface of the fastener base and the additional channel is on the lower surface of the fastener base.

7. The apparatus of claim 4, wherein the additional tube comprises an additional ET tube, a nasogastric tube, or an orogastric tube.

8. The apparatus of any one of claims 1 through 7, wherein the fastener base of the ET the tube fastener comprises a series of markings adjacent the channel on the fastener base.

9. The apparatus of any one of claims 1 through 8, wherein the frame is a length-adjustable frame including at least one slide part located along a length of the frame and configured to be movable with respect to the frame in a length direction of the frame.

10. The apparatus of any one of claims 1 through 9, wherein the frame includes one or more living hinges along the length of the frame, the hinge is configured to allow for an adjustment of angle at which the frame sits on the preauricular area of cheek of the patient.

11. The apparatus of any one of claims 1 through 10, wherein the frame includes a hinge at each opposite end of the frame, the hinge is configured to allow for a swivel movement of the attachment pad in relation to the frame when the attachment pad is coupled to the frame.

12. The apparatus of any one of claims 1 through 10, wherein: the pad attachment pads individually include a keyhole adjacent to one end thereof; andthe frame includes a protruding key opposite end portion of the frame, the protruding key feature having a specific shape and size adapted for fitting within the keyhole of the pad attachment pads in one orientation, wherein the keyhole of the individual pad attachment pad and the protruding key feature of the frame are configured to allow for a swivel movement of the attachment pad in relation to the frame when the keyhole of the individual pad attachment pad are engaged with the protruding key feature of the frame.

13. The apparatus of any one of claims 1 through 10, wherein: the frame includes a hook feature at each opposite end portion of the frame 100; and the pad attachment pads individually include an opening adjacent to one end thereof, the opening configured for allowing a slide movement of the opening through a track of the hook feature of the frame toward the frame to secure the pad attachment pad to the frame, wherein the opening of the individual pad attachment pad and the hook feature of the frame are configured to allow for a swivel movement of the attachment pad in relation to the frame when the opening of the individual pad attachment pad are engaged with the hook feature of the frame.

14. The apparatus of 13, wherein the pad attachment pads individually further include a raised bumper adjacent to an opposite end of the pad attachment pad.

15. The apparatus of any one of claims 1 through 14, wherein the securing structure further comprises a gripping element connecting to the second securing element, the gripping element adapted for pulling the second securing element toward the first securing element or away from the first securing element.

16. The apparatus of any one of claims 1 through 15, wherein the frame includes an attaching feature configured for receiving and securing an additional tube.

17. An endotracheal tube securement apparatus, comprising: a frame having a curve shape projecting outwardly away from a mouth or nose of a patient, the frame including opposite ends and a mid-portion between the opposite ends;an endotracheal (ET) tube fastener for coupling to the frame and adapted for receiving and securing an ET tube, the ET tube fastener including a securing structure for securing the ET tube to the ET tube fastener, the securing structure including a first securing element and a second securing element having a complementary structure to the first securing element and configured for removably engaging with the first securing element; attachment pads configured for coupling to the opposite ends of the frame and for anchoring to a preauricular area of cheek of the patient; and skin adhesive pads having one side configured for coupling to the attachment pads and an opposite side configured for a removable attachment to the preauricular area of cheek of the patient.

18. The apparatus of claim 17, wherein the frame further includes an auxiliary attaching feature configured for receiving and securing an additional tube thereto, the auxiliary attaching feature includes support straps each disposed between the mid-portion of the frame and one opposite end of the frame, the support straps individually comprising: a front portion connecting a front end of the mid-portion of the frame to the one opposite end of the frame; and a rear portion connecting a rear end of the mid-portion of the frame to the same one opposite end of the frame, the rear portion spaced apart from the front portion by a gap; 19. The apparatus of claim 18, further comprising an auxiliary fastener configured for coupling with the auxiliary attaching feature of the frame to receive and secure the additional tube.

20. The apparatus of claim 19, wherein the auxiliary fastener includes: an auxiliary base having a rear surface and a front surface; and an auxiliary securing structure on the front surface of the auxiliary base, the auxiliary securing structure comprising: a securing knob; andan elastic strap adapted for a portion of the additional tube, reversibly hooking onto the securing knob, and securing the additional tube to the frame.

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