Avoiding Tracheal Tube Care Accidents: Elongation of Tracheal Tube Securing Straps

Research Article

Austin J Otolaryngol. 2014;1(1): 2.

Avoiding Tracheal Tube Care Accidents: Elongation of Tracheal Tube Securing Straps

Yen-Liang Chang1, Ming-Hsu Chen1 and Shih-Han Hung2*

1Department of Otolaryngology Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan

2Department of Otolaryngology, Taipei Medical University Hospital, Taipei, Taiwan

*Corresponding author: Shih-Han Hung, Department of Otolaryngology, Head & Neck Surgery Taipei Medical University, No.252, Wu-Hsing Street, Taipei City 110, Taiwan

Received: June 28, 2014; Accepted: July 29, 2014; Published: Aug 01, 2014


Purpose: Tracheal tube securing straps are essential in maintaining adequate tube function. In this study, we attempted to test and analyze some commonly used tracheal tube securing straps.

Methods: Five different straps were tested under stress in dry and wet conditions. Certain elongation properties under stress on tracheal tube securing straps should be noticed.

Results: The dampening of the tracheal straps seems not likely to affect the elongation properties (P>0.5). The most affected strap is the elastic strap (3.96% & 3.59% elongation, wet: dry).The cotton twill strap is the least to be extended (0.42% & 0.63% elongation, wet: dry).

Conclusion: Traditional cotton twill straps remain to be most reliable choice. We propose and recommend that all tracheal straps be Pre-Stretched before use. Protocols able to stabilize tracheal tube strap will be likely to improve patient safety and avoid tube mal position accidents.

Keywords: Tracheal tube; Elongation; Strain; Securing strap


Endotracheal intubation and tracheostomy are two common procedures in the practice in many fields of clinical medicine. After the procedure was completed, a tracheal tube was placed to protect and secure the airway. Traditionally, tracheal tubes were secured by simple straps or sticky tapes tied on the tube and surrounding the face or neck. However, according to many clinical experiences, although this securing method is simple, efficient, and easy to care, besides the adhesive properties of the sticky tape, the efficacy of the securing method largely depend on the stability and elongation properties of the securing straps. In any cases of whether during the treatment or bath, or contaminated by body fluids, the length of the securing straps could have increased, and subsequently leads to the dislocation of the tracheal tube and even leads to a life threatening conditions, if the upper-airway is compromised.

In this study, we attempted to record and analyze the different response to dry and wet conditions of many clinically/commercially available tracheal tube securing straps.

Material and Method


Tracheostomy securing straps commonly used in clinical practice were used, including two commercially available tracheostomy straps, common elastic straps, ribbon straps, and common cotton twill straps.

Length elongation measurement

The tension forces of a tightened tracheostomy tube straps was measured with an electronic tension meter (WH-A12, Wei Heng, Taiwan) and set at 400gw. The length of the strap surrounding the neck is around 40 cm.

All straps were secured at one end on a fixed shaft as shown in Figure 1. On the other end, a weight of 400gwwas applied and secured. A 40 cm gap was marked on the strap and the length recording began once the weight was applied. The length recording was done at 6, 12, 24, 48, and 72 hours. In the dry group the straps were kept dry under room air and room temperature. In the wet group, the straps were continuous irrigated with saline to keep the straps in the wet condition.