Stabilisation of an Endotracheal Tube for the Adult Intensive Care ...

Number Statement: General
The ventilator tubing should be supported by a ventilator
Grade of
recommendation
6
arm that keeps the patient’s head in the midline and
prevents pressure on the lips.
17
Consensus Opinion
Maintaining tube alignment within the trachea is dependant on two factors: 1) security of
stabilisation method; and 2) use of ventilator arms to hold the weight of the ventilator tubing
and preventing traction on and movement of the ETT. Study findings identify significant
discomfort from tube movement (Johnson and Sexton 1990; Grap, Glass et al. 1995;
Pochard, Lanore et al. 1995). The pressure on the lips created by the unsupported weight of
ETT and ventilator tubing may compromise the microcirculation of the lips and lead to a
pressure area. Therefore, for reasons outlined earlier and to promote patient comfort, use of
additional supports, such as ventilator arms, to prevent unnecessary ETT movement are
recommended. It should be noted however that the level of the ventilator arm must keep the
ventilator tubing in a position that prevents the backwash of any fluid into the patient. The
EVP endorsed this recommendation.