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Decreasing unplanned extubations in the surgical intensive care unit
G T Tominaga1, H Rudzwick, G Scannell
1Department of Surgery, University of California Irvine Medical Center, Orange 92668, USA.
American Journal of Surgery
|December 1, 1995
Summary
Securing endotracheal tubes with waterproof tape significantly reduces accidental extubations. Routine use of hand restraints is also recommended to prevent unplanned extubations in intensive care units.
Area of Science:
- Critical Care Medicine
- Patient Safety
- Surgical Intensive Care
Background:
- Unplanned extubations pose a significant risk to intubated patients.
- These events can lead to life-threatening complications.
Purpose of the Study:
- To evaluate the impact of endotracheal tube fixation methods on accidental extubations.
- To assess the influence of sedation/paralysis and hand restraints on extubation risk.
Main Methods:
- Prospective evaluation of intubated patients in a surgical intensive care unit.
- Examined three parameters: tube fixation, sedation/paralysis, and hand restraints.
- Modified parameters sequentially across study periods.
Main Results:
- Waterproof tape significantly decreased accidental extubations (P < 0.0001).
- Liberal sedation did not affect extubation frequency.
- Restricted use of hand restraints significantly increased accidental extubations (P < 0.001).
Conclusions:
- Water-resistant tape is effective for securing endotracheal tubes.
- Routine use of hand restraints is advised to prevent unplanned extubations.