The Difficult Airway

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Thomas Study

This study compared two methods of securing an endotracheal tube in adults: tying with a cloth tape versus the Laerdal Thomas Endotracheal Tube Holder.  Paramedics and physicians conducted this study.  Each was required to secure the ETT using tape & the Thomas device 3 times each.  Once secure, the security of the tube was tested by applying a fixed force laterally and to the right by dropping a 1.25 kg weight a distance of 50 cm. The amount of movement of the tube with respect to the teeth was measured and recorded in millimeters. A total of two-hundred-and-seventy tube fixations (135 tied vs. 135 Thomas) were performed by 45 participants. The degree of tube movement was significantly higher when the tube was secured with a tie compared with when the tube holder was used (median movement 22 mm vs. 4 mm, P < 0.0001). The results demonstrated that the Thomas device was more successful in maintaining proper endotracheal tube placement.  [37]

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