An Alternative for Endotracheal Tube Holders In Resource-Limited Settings

Background: Endotracheal intubation (ETT) is a procedure that is lifesaving and performed in intensive care units, in operating theatres to facilitate surgery, and in emergency departments. Unplanned extubation causes hypoxia and death. The Advanced Cardiac Life Support Guidelines in 2005 by the American Heart Association recommend using either an adhesive tape or ETT holder to secure the ETT. The commercially available single-use adult ETT holders cost approximately 2000-2500 LKR. Purpose: The objective of this report is to highlight how a low-cost ETT holder can be created in a low-resource country as a substitute for commercially available ETT holders during an economic crisis.Procedure: A polyvinyl-chloride (PVC) female pipe adapter with a slit on the thread end, and a male adapter were used. The ETT was placed vertically within the slit of the female adaptor. The adapters were screwed together to hold the ETT. Two separate cylindrical PVC pipes with a hole on each end were attached to either side of the female and male pipe adapters. Fabric threads were passed through the openings of the cylindrical pipes to create a harness. Results: Our device secured the placement of ETT without dislodgement. Material for each ETT costs 400-500 LKR and can be constructed within 30 minutes. They can be autoclaved and reused.Conclusion: A low-cost locally manufactured PVC ETT holders can be an ideal substitute for the commercially available ETT holders.