Endotracheal tube stabilization using an orthodontic skeletal anchor in a patient with facial burns

Ivy Loop Wiring: A Useful Form of Endotracheal Tube Stabilization in Burn Patients

The stabilization of endotracheal tubes in the burn population presents many problems. Access to the face for dressings, debridements, and the use of topical antimicrobials prevent adequate stabilization of the endotracheal tube with commonly used methods. Conventional methods have an increased risk of shifting, which can lead to injury to the friable burned tissue or unplanned extubation. To prevent these complications, alternative methods using the dentition to stabilize the endotracheal tube have been described. Here, we present our technique of using Ivy loops to secure the endotracheal tube. It is a simple method with low complications that provides a strong stabilization of the tube while giving access to the face.

Use of Modified Statlock™ Device for Securing an Endotracheal Tube in Facial Burn-Like Conditions

The Statlock(™) is an IV stabilization device developed by Bard Access Systems, Inc. We describe the use of a modified Statlock with tracheostomy ties to provide a secure anchor for an endotracheal tube in a child with toxic epidermal necrolysis. We review the benefits and drawbacks of previously described devices in patients with similar conditions (burns, epidermolysis bullosa, Stevens Johnson syndrome). We demonstrate creation of this system with readily available supplies to provide an accessible and stable airway in patients with facial injury precluding adhesive use.

Easy come, easy go: a simple and effective orthodontic enamel anchor for endotracheal tube stabilization in a child with extensive facial burns

Endotracheal tube stabilization in patients with facial burns is crucial and often challenging. We present a simple method of securing an endotracheal tube using two orthodontic brackets bonded to the maxillary central incisor teeth and a 0.08'' stainless steel ligature wire. Our technique is less traumatic, and is easier to maintain oral hygiene than with previously described methods. This anchorage system takes 5 min to apply and can be removed on the ward without the need for a general anaesthetic.