Adjustable ETT Securement Mechanism for Neonatal Extubation Prevention
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Solution Overview
Problem
Current devices for securing endotracheal tubes in young patients, such as infants and small children, are often sub-optimal due to poorly designed gripping mechanisms and adverse reactions to adhesives, leading to unplanned extubations and complications.
Innovation Solution
A device with an elongated body featuring a hinge and a releasable securement mechanism, which includes teeth and grooves for engaging to securely hold an endotracheal tube in place, allowing for adjustable positioning and securement to the patient's face using an adhesive means.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If adhesive tape or adhesives are used to secure the endotracheal tube, then the tube can be fixed to the patient, but the adhesive causes adverse reactions on the newborn baby's skin and may become difficult to remove
Solution Approach 1:
The device divides the securement function into separate components: an adhesive-free mechanical gripping mechanism (first and second gripping members with teeth) that contacts the tube, and a separate adhesive layer only on the device body that contacts the patient's skin. This segmentation isolates the harmful adhesive from direct contact with both the tube and the sensitive skin, resolving the contradiction between reliable securement and skin safety.
Solution Approach 2:
The device body acts as an intermediary between the endotracheal tube and the patient's skin. The mechanical gripping members securely hold the tube without adhesives, while the device body with its limited adhesive area mediates the connection to the skin, reducing direct adhesive-skin contact and minimizing adverse reactions.
2Reliability
If hook and loop fasteners are used to secure the endotracheal tube, then the tube can be attached to the patient's face, but the fasteners may become too loose causing the tube to slip or too tight preventing suction catheter passage
Solution Approach 1:
The device incorporates a dynamic adjustment mechanism where the first and second gripping members can be repositioned along the longitudinal axis of the device body. This allows the securement force to be dynamically adjusted to an optimal level that prevents tube slippage while maintaining sufficient space for suction catheter passage, resolving the contradiction between reliable securement and operational ease.
3Reliability
If tabs or lollipops are used to secure the endotracheal tube, then the tube can be attached to the patient's face, but the tabs become loose and lift from the patient's face
Solution Approach 1:
The device replaces the single-tab design with separate first and second gripping members that independently contact the tube. Each gripping member has its own adhesive attachment point on the device body, distributing the securement load and preventing the loosening and lifting issues associated with single tabs or lollipops.
4Reliability
If the endotracheal tube is secured too tightly to prevent migration, then unplanned extubation is prevented, but the device blocks access to the oral cavity making oral care difficult
Solution Approach 1:
The device concentrates the securement function at specific localized gripping points (first and second gripping members) on the tube, while leaving the rest of the device body minimal and non-obstructive. This localized approach provides strong tube securement to prevent unplanned extubation while maintaining clear access to the oral cavity for nursing care activities.
Data Source
AI summary
The present disclosure generally relates to devices, and related methods of treatment using the same, for securing an endotracheal tube (commonly abbreviated as “ETT”) or other medical line to a patient, and more particularly to infants, babies in a neonatal unit, small children, etc.). The disclosure also relates to techniques and devices to remove the presence of unplanned extubations. In an exemplary embodiment, as taught in the present disclosure, a device may be used to secure an endotracheal tube to a small child or newborn infant such that the device may be configured to adjust the grip of the endotracheal tube to achieve optimal securement and stabilization of the endotracheal tube.