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August 1989

Prevention of Accidental Extubations in Newborns

Author Affiliations

Associates in Neonatology Lee Memorial Hospital 2780 Cleveland Ave Suite 703 Fort Myers, FL 33901

Am J Dis Child. 1989;143(8):880-881. doi:10.1001/archpedi.1989.02150200016007

Sir.—We read with interest the article by Brown1 that appeared in the November 1988 issue of AJDC concerning accidental extubations in newborns.

We have used a variation of the pinning method for endotracheal tube stabilization at our nursery for the past 4 years. This method is illustrated in the Figure. Our method is used exclusively in orally intubated newborns. The newborn's face is prepped with a tincture of benzoin, and elastic tape (Elastikon, Johnson and Johnson, New Brunswick, NJ) is used as illustrated. A 2.5-cm safety pin (presterilized) is carefully placed to minimize mechanical compromise of the endotracheal tube lumen. Shiley (Shiley Inc, Irvine, Calif) uncuffed pediatric oral/nasal murphy endotracheal tubes are primarily used. It does take an initial orientation to become familiar with the technique, but once learned, respiratory therapists and nurses have reported minimal morbidity. We have found no problems with suctioning past the pin. In

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