Unplanned Extubation is Preventable

Prevention of unplanned premature extubation begins with securement. As noted above multiple authors have described the absence of an optimal endotracheal tube stabilizer for patients of any age.^{15,20-22,24-26,28,30,34,54-56}

Attributes of the optimal securement device include: ^{20,22,31,33,57}

• Easy to apply and maintain
• Adequate stabilization of the tube against external forces that risk dislodgement
• Prevention of tube movement >3.5 cm
• Security is not compromised when the device is exposed to blood, saliva, or other fluids
• Secures the endotracheal tube without compressing the tube and decreasing the internal diameter
• Enables movement of the tube in the mouth for oral care and ulceration prevention without jeopardizing the position of the distal tip
• Facilitates suctioning of the tube and oropharynx without risk of tube movement
• Allows good visualization of the oral cavity
• Requires infrequent adjustment or change