Karn Suttapanit(0000‐0002‐7533‐6663), Chaiyaporn Yuksen*(0000‐0002‐4890‐7176), Kasamon Aramvanitch(0000‐0002‐5995‐3370), Thitapohn Meemongkol(0000‐0003‐3012‐8227), Arnon Chandech(0000‐0002‐5552‐2442), Benjamat Songkathee(0000‐0003‐0474‐6355), Promphet Nuanprom(0000‐0001‐7523‐8353)

Department of Emergency Medicine, Mahidol University, Bangkok, Thailand

Keywords: Adhesive tape, endotracheal tube displacement, Thomas tube holder


OBJECTIVES: Endotracheal tube (ETT) displacement occurs by improper fixation. To fix an ETT, many types of fixation tools are employed. Thomas tube holder is one of the fixation tools widely used in many countries. This study aims to compare the ETT fixation using the Thomas tube holder with the conventional method (adhesive tape) in a mannequin model.

METHODS: The fixation tools were random, using the box of six randomizes to Thomas tube holder and conventional method. After fixation, the mannequin model was being logged roll, chest compression by automated chest compression machine, and transported by the paramedic. The time to ETT fixation and displacements were recorded.

RESULTS: The mean time (standard deviation) to fixate an ETT was shorter (33.0 s [7.3]) with a Thomas tube holder compared to adhesive tape (52.6 s [7.3], P < 0.001). The number and proportion of the ETT displacements were significantly less with Thomas tube holder compared to adhesive tape during log roll (16, 35.6% vs. 29, 64.4%, P = 0.011), chest compression with automated machine (23, 51.1% vs. 37, 82.2%, P = 0.003), and transport (26, 57.8% vs. 40, 88.9%, P = 0.002).

CONCLUSION: The Thomas tube holder is more effective than adhesive tape in preventing ETT displacement in a mannequin subjected to log roll, chest compressions, and transportation.

Ethics Committee Approval

This study was approved by the committee on Human Rights Related to Research Involving Human Subjects, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand (MURA2017/883).

Author Contributions

KS and CY conceived and designed the experiments, and defined the intellectual content; TM and AC performed the literature search, KA, TM, AC, BS and PN performed the experiments; AC, BS and PN acquired the data and analyzed the data; CY and KA performed the statistical analysis and interpreted the data; CY and KS drafted the manuscript. All authors reviewed and confirmed the final draft of the manuscript.

Conflict of Interest

None Declared.

Financial Disclosure

None declared.


We thank Angela Morben, DVM, ELS, from Edanz Group (www.edanzediting.com/ac), for editing a draft of this manuscript.