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Resuscitation. 2009 Nov;80(11):1296-300. doi: 10.1016/j.resuscitation.2009.08.007. Epub 2009 Sep 1.

Extubation force: a comparison of adhesive tape, non-adhesive tape and a commercial endotracheal tube holder.

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  • 1Emergency Medical Services, Hamad Medical Corporation, Doha, Qatar.



This study compares adhesive tape, non-adhesive tape and a commercial endotracheal tube holder in terms of the force required to extubate endotracheal tubes from a cadaver.


A newly deceased, unembalmed cadaver was orotracheally intubated. Senior paramedic students secured the endotracheal tube using adhesive tape applied using the Lillehei method, non-adhesive tape and the Thomas Tube Holder in a random order. The time taken to secure the endotracheal tube and the force required to remove the distal tip of the endotracheal tube from the glottis were recorded.


Use of adhesive tape using the Lillehei method resulted in greatest resistance to tube dislodgement, although it took significantly longer to apply than the other two methods.


Although the Lillehei method provided the greatest resistance to tube dislodgement, it may not be ideal for the prehospital or emergency department context. The Thomas Tube Holder was quick and effective and may provide a good compromise in these environments, although once time is no longer important, clinicians may elect to revert to the Lillehei method which provides greater security.

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