An endo-tracheal tube holder comprises a web or strap including separable fasteners at the ends of flexible material of the web for adjusting the size of a loop formed by the web, and an adjustable tube retaining means secured to the web.

BACKGROUND OF THE INVENTION 
1. Field of the Invention 
The invention relates to an apparatus for securely and conveniently holding 
an endo-tracheal tube in position in relation to a patient's mouth, during 
a medical procedure. 
2. Description of the Prior Art 
Prior endo-tracheal tube holders have suffered from a lack of continuous 
adjustability and of ease of operation. For example, one type of tube 
holder includes a plastic mouthpiece partially insertable within the 
patient's mouth. The mouthpiece includes a hole formed therein for 
receiving the endo-tracheal tube, and a spring clamp for retaining the 
tube. A strap is attached to the mouthpiece and adapted to extend around 
the patient's head or neck. Typically, the strap includes a buckle, by 
means of which the length of the strap is adjustable in increments. 
Such tube holders operate effectively to maintain endo-tracheal tubes in 
position, but suffer from several drawbacks. Such devices are 
unnecessarily complicated and expensive. Furthermore, the incrementally 
adjustable strap buckle does not in all cases provide the desired secure 
attachment, as well as patient comfort. To provide some tolerance in 
adjustability, straps have been made elastic to a greater or lesser 
degree, but elastic straps offer less control, and are more expensive to 
manufacture. Finally, tube holders including formed plastic mouthpieces 
are somewhat bulky, causing problems and storage and inventory. 
There is a need therefore for a simple endo-tracheal tube holder, which is 
inexpensive to manufacture. Other desired features include a compact size 
to facilitate storage, and ease of use. Finally, as with all medical 
equipment, reliability is of utmost importance. 
SUMMARY OF THE INVENTION 
It is, therefore, an object of the invention to provide an endo-tracheal 
tube holder including a strap and fastener permitting a continuous, rather 
than an incremental, adjustment of the length of the loop formed by the 
strap. It is another object of the present invention to provide such an 
endo-tracheal tube holder in which the clamp means for the tube comprises 
a simple, one-piece adjustable loop of thermoplastic material. 
A tube holder according to the invention comprises a web or strap typically 
formed of a strong, substantially inelastic flexible woven fabric. The web 
is of a size suitable for extending around the jaw and behind the upper 
neck of a patient. The two free ends of the web include fasteners which 
are engagable at any point throughout a predetermined range of overlap of 
the strap ends of the web. When the web is placed in position around a 
patient's head, the ends are overlapped to form a loop which is 
continuously adjustable in length to securely position the endo-tracheal 
tube without undue constriction. 
A tube retaining means or clamp including a small loop of thermoplastic 
material is secured to the web intermediate the ends thereof. The loop of 
the retaining means is also adjustable in length, to securely grip the 
endo-tracheal tube.

DESCRIPTION OF THE PREFERRED EMBODIMENT 
Referring to FIG. 1, an endo-tracheal tube holder 10 is illustrated in 
operative position on a patient's head, retaining an endo-tracheal tube 12 
in the appropriate position. As best seen in FIG. 2, the tube holder 10 
includes a web or strap 14, fasteners 16 and 18 on respective ends of the 
strap 14, and a tube retaining means or clamp 20 secured to the strap 14. 
The strap 14 is preferably formed from a strong, flexible, woven fabric, 
having minimal stretch. For proper fitting around a patient's neck and 
jaw, as illustrated in FIG. 1, the strap 14 is typically of a length of 
the range of approximately 50 centimeters. The length of the loop formed 
by the strap 14 is preferably adjustable by varying the extent of the 
overlap of the ends, within a range of approximately 35 to 50 centimeters. 
The fasteners 16 and 18 provide this necessary adjustability. The fastener 
16 comprises a fabric strip having a pile nap surface 22 including a 
myriad of looped threads. The fastener 18 comprises a strip having a 
plurality of small hooks formed of thermoplastic material, engagable with 
the pile surface of the fastener 16. Such fasteners are commercially 
available, and marketed under the trademark Velcro. The fasteners 16 and 
18 are secured to opposite ends of the strap 14, preferably by stitching 
26. 
The tube retaining means or clamp 20 includes an integrally formed, 
elongate thermoplastic body portion 29 of a size capable of being formed 
into a loop of a desired size. A illustrated in detail in the sectional 
veiw of FIG. 3, one end of the body portion 29 terminates in a small 
housing 28 having a channel 30 formed therethrough to receive the opposite 
end of the body portion 29. The housing 28 further includes an integrally 
formed, resilient pawl 32 engagable with an elongate array of serrations 
34 formed on one surface of the body portion 29. The serrations 34 include 
inclined camming surfaces 36 so formed to cam past the pawl 32. The 
serrations 36 also include detent surfaces 38 which are positively 
engagable with the pawl 32. In effect, the body portion 29 and the housing 
28 cooperate to form a rack and ratchet mechanism permitting relative 
movement in only one direction. The one end of the body portion 29 may be 
freely pulled through the channel 30 in the direction to decrease the 
dimension of the loop so formed and tighten the same onto an endo-tracheal 
tube 12. The pawl 32 and serrations 36 cooperate to militate against 
retrograde movement and thereby prevent the loosening of the clamp 20 
during use of the tube holder 10. 
The clamp 20 is preferably secured to the strap 14 by insertion of the body 
portion 29 through aperture means 40 formed at appropriate locations in 
the strap 14, prior to forming the loop of the clamp 20. The aperture 
means 40 are longitudinally spaced and centrally located between the 
longitudinal edges of the strap 14. 
To use the endo-tracheal tube holder 10, the strap 14 is placed around the 
chin and the base of a patient's head, as illustrated in FIG. 1. The 
fasteners 16 and 18 are pulled to an overlapping relationship providing a 
snug fit of the strap 14 around the patient. Manual pressure on the 
fasteners 16 and 18 is sufficient to assure engagement of the hooks 24 
with the pile surface 22, and thereby secure the strap 14 in position. To 
provide for the desired amount of adjustability, the fastener 16 may have 
a length of approximately 10 to 15 centimeters, the fastener 18 being 
engagable at any location thereon. 
An endo-tracheal tube 12 can then be rapidly and reliably fixed in place 
relative to the strap 14 and the patient by placing it within the loop of 
the clamp 20, and tightening the clamp 20 thereon by pulling the free end 
of the serrated strip 29. 
The endo-tracheal tube holder 10 thus described offers several important 
advantages. The fasteners 16 and 18 permit continuous adjustment of the 
length of the loop of the strap 14. Manipulation of the fasteners 16 and 
18 is simple in comparison with other fasteners such as the buckle type, 
for example. Release and readjustment of the fasteners 16 and 18 can be 
readily effected merely by pulling the fastener 16 away from the fastener 
18, then repositioning and again pressing together the two fasteners 16 
and 18. The clamp 20 also offers a simple and reliable means for holding 
an endo-tracheal tube, in comparison with bulkier, less easily manipulated 
spring-type clamps. Finally, the entire tube holder apparatus 10 can be 
inexpensively manufactured from commercially available components and is 
expendable. 
In accordance with the provision of the patent statutes, the principle and 
mode of operation of the apparatus have been explained and what is 
considered to represent its best embodiment has been illustrated and 
described. It should, however, be understood that the invention may be 
practiced otherwise than as specifically illustrated and described without 
departing from its spirit or scope.