Prevention of accidental extubation in newborns
M. S. Brown
Department of Pediatrics, University of Colorado Health Sciences Center, Denver.
Maintaining endotracheal intubation is critical to treating respiratory
failure in newborns. To reduce accidental extubations in our neonatal
intensive care unit, a prospective comparison of rates of extubation was
made between two taping methods and whether or not a head restraint was
used. One tape method was significantly better at preventing accidental
extubations. Head restraint was not a benefit when used prospectively.
Factors that preceded or were associated with accidental extubation
included the time intubated, infant agitation, endotracheal tube
suctioning, the infant turning its head, chest physiotherapy, loose tape,
too short a tube between lip and adapter, weighing, and endotracheal tube
taping. This information and the study design are valuable in developing
strategies to minimize accidental endotracheal extubation and the
subsequent risks of airway injury and subglottic stenosis in sick newborns.
