ET, Gastric Suction & Feeding Tube

Quick Facts

  • The ArcAngel is an endotracheal tube holder. It can secure 2 tubes independently of each other (ETT along with feeding tube or gastric suction)
  • Once tubes are placed in the grooves, they never need to come out. Adjustments are made by opening the outer locking ring and advancing or retracting tubes while remaining secure in their specific groove
  • Saves time and resources and increases staff confidence as one clinician can make precise 0.25cm adjustments in seconds
  • Communication between caregivers is more exact as visualizing tube position is not obstructed by tape. Eliminates skin excoriation/breakdown from repeated tape removal and reapplication
  • Eliminates skin trauma during an emergency—removal of adhesive can always be done in a controlled setting. Arms slide out while cheek pads remain on face
  • Cheek pads may remain on baby’s face during CPAP/NC trial. If baby requires reintubation, you can reuse the arc and insert right back into existing cheek pads
  • ArcAngel can be reused, provided that the baby is intubated with same size ETT
  • Visibility at the mouth allows for accurate documentation of tube position and proper oral care/oral swabbing
  • Increases staff satisfaction as time can be spent on other care tasks
  • Increases parental satisfaction as there is little obstruction of their newborn’s face
  • Silicone adhesive on cheek pads is hypoallergenic, repositionable, secure and gentle on the skin
  • Cheek pads can last 7-10 days on the skin—replacement pads are available
  • Silicone cheek pads can be cleaned with alcohol swab or baby wipe if they get soiled
  • Metal and latex free
  • ArcAngel can be used to secure gastric suction tubes on surgical patients
  • Adjustable for a custom fit for every baby
  • All tubes can be secured orally or nasally or a combination of the 2
  • ETT remains midline when orally inserted
  • Standardizing ETT securement promotes safety and decreases unplanned extubation from various taping methods


How do I know what size of ArcAngel to use?

Sizing of the Arc is based on the size of the ET tube size used.

Tube Sizes
Infant Weight Size ETT Size Gastric
400-1000gm 0 2.5mm 6F 5F
1001-2500gm 1 3.0mm 8F 6.5F
2501-4000gm 2 3.5mm 10F 6.5F
4001gm+ 3 4.0mm 10F 6.5F

How are tubes adjusted independently of each other?

The innovative twist-lock technology allows for keeping one tube secure while the other can be freely adjusted. Open the locking ring to the desired tube holder groove. Make your adjustment by advancing or retracting your tube while remaining in the groove. Twist ring to lock in place.

How many people does it require to make an adjustment to a secured tube? Is a tape measure required?

It takes one clinician seconds for the adjustments. No tape measure is need as you can use the 0.25cm hashmarks on the outer ring as your guide.

How do I remove the ArcAngel in an emergency?

In an emergency or for trial extubation, the ArcAngel can be removed by holding the cheek pads in place, gently pulling the ArcAngel out of the cheek pads, leaving the pads and any additional tube intact. The same ArcAngel can be inserted back into the cheek pads for continued use if needed.

Can you use in-line suction for the ETT with ArcAngel?

Yes. There is no outer compression on the tube. It is held in place by friction alone.

Does ArcAngel contain latex or metal?

No. It is MRI safe.

Where do I place the cheek pads?

Simply place the cheek pads directly in front of the ear. Nasal vs oral intubation will determine the position height to insure the proper alignment of the ETT. Designed with baby’s facial contour in mind there is no need to trim the cheek pads. There are 2 interchangeable sizes available from a custom fit.

How is the cheek pads adhere to the face?

An oversized silicone adhesive is used to secure the cheek pads. The adhesive should last 7 – 10 days.

What happens if the cheek pads get soiled?

They can be cleaned with a baby wipe or alcohol swab.

How are the cheek pads removed?

Baby soap and water or mineral oil.

Why are there 3 grooves on the top and 3 grooves on the bottom?

Any tube (ETT, feeding, or gastric suction) being inserted nasally will use the 3 top grooves. Any tube inserted orally with use the 3 bottom grooves. Any combination of nasal/oral insertion will work.

Can the ArcAngel be reused?

The ArcAngel can be used for the entirety of the patient’s stay if the ETT remains the same size. Cheek pads can be replaced after 7 – 10 days if needed. It is single-patient use.

What if my patient needs one size ArcAngel but a different size tube won’t fit in the grooves?

The ArcAngel can be used alongside additional adhesive if needed. Also, the French sized grooves are interchangeable between feeding and gastric suction tubes. For example, your patient needs a size 0 ArcAngel to secure a 2.5 ET Tube but you would like to use a 6F feeding tube instead of a 5F. Since the suction tube on a size 0 ArcAngel is a 6F, refer to the raised French sizes on the barrel of the ArcAngel to identify groove sizes.

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