A Modified Tie Technique for Securing Endotracheal Tubes.

Area of Science:

• Medical Devices
• Patient Safety
• Critical Care Engineering

Background:

• Unintentional extubation is a critical patient safety issue with limited research on prevention.
• Current methods for securing endotracheal tubes (ETTs) lack robust evidence for optimal effectiveness.
• There is a need for improved techniques to secure ETTs and prevent accidental dislodgement.

Purpose of the Study:

• To develop and evaluate a novel knot for securing endotracheal tubes.
• To compare the slippage resistance of the new knot against conventional methods.
• To assess the efficacy of different knots under simulated clinical conditions.

Main Methods:

• A weighted apparatus was used to test knot slippage under perpendicular and sliding forces.
• Knots were tested in both dry and wet conditions to mimic the clinical environment.
• A manual manipulation test assessed the knot's resistance to sliding forces.

Main Results:

• The novel double hitch knot demonstrated no slippage under any tested conditions (weight, wet/dry, sliding forces).
• Conventional knots, including the normal knot and clove hitch, showed varying degrees of slippage, especially when wet.
• The modified cow hitch also withstood all weights but was not tested for sliding resistance.

Conclusions:

• The developed double hitch knot is superior to conventional methods for securing endotracheal tubes.
• This new knot offers a promising solution for preventing unintentional extubation, particularly in high-risk settings like the ICU.
• Further clinical implementation of the double hitch knot could significantly enhance patient safety.