Reducing Strangulation Hazards from Medical Device Tubing and Wires

Medical device tubing and wires can become wrapped around a patient's neck or extremities, leading to asphyxiation or the loss of fingers, toes, or limbs. Patients may have multiple thin, flexible tubes or wires in their vicinity that can act as a ligature should the patient turn. Entanglement hazards are a known risk for any patient who is connected to IV tubing, an enteral feeding line, ECG lead wires and trunk cables, pulse oximeter cables, oxygen tubing, or other flexible medical device accessories. Events have been reported in the home environment, as well as in institutional care settings.

The risk of harm is particularly acute for individuals who do not have the awareness or ability to extricate themselves if they become entangled. For example: Infants are unlikely to recognize that the ligature around their neck is depriving them of oxygen, and they may not have sufficient flexibility or motor control to respond. The same could be true of a geriatric patient whose cognitive ability has declined due to illness such as Alzheimer's disease. An additional concern for infants is that the force required for asphyxiation is small. (1)

The risk is further increased if patients can move around more easily than caregivers assume, making...