Design and Experimental Evaluation of an Integrated Endotracheal Tube Securement Device for Simulated Airway Management

Abstract

Endotracheal tube securement devices must maintain tube stability while allowing access for oral care, suctioning, and management of additional tubes. This study describes the development and experimental evaluation of an integrated airway securement device designed to stabilize an endotracheal tube, nasogastric tube, and bite block on a single platform. The device was developed through an iterative co-design process and evaluated against a conventional tube fixation method in a randomized crossover simulation study. Thirty-four nursing students completed two airway-care scenarios on an intubation mannequin: emergency stabilization and routine maintenance. Performance metrics included procedure time, fixation stability under externally applied loads, and user-rated usability. Compared with the conventional method, the device significantly reduced procedure time in both emergency stabilization and routine maintenance by 139.6 s and 428.9 s, respectively. Fixation stability was greater for the endotracheal tube at 700 and 1000 g, for the nasogastric tube at 200, 300, and 500 g, and for the bite block at 500, 700, and 1000 g. Usability scores were also higher for the device. These findings support the feasibility of the proposed design and suggest that the device may improve workflow efficiency and multi-tube securement performance in simulated airway management. Clinical evaluation in real-world settings remains necessary.