The HORSESHOE™ Face-Free Design Addresses Airway Securement Challenges

Securing an endotracheal tube is one of the most critical responsibilities in airway management, yet it remains a persistent challenge in critical care. Traditional securement methods often rely on tape, adhesives, facial straps, or improvised solutions that can become unreliable in the presence of moisture, edema, facial hair, fragile skin, or patient movement. Clinicians must balance tube stability, patient safety, skin integrity, and access for oral care, all while minimizing the risk of unplanned extubation and device-related complications.

The HORSESHOE airway security device was developed to address these challenges in a different way. Rather than relying on the face as an anchor point, the device secures the airway intraorally using integrated Molar Props™ that engage the posterior teeth and leverage natural jaw biomechanics. This face-free design provides a versatile solution for many patient populations that traditionally present significant airway securement difficulties.

The Wide Range of Patient Populations That Benefit from the HORSESHOE

Patients with compromised skin integrity may benefit most from the HORSESHOE. Burn patients, patients with skin grafts, and individuals with fragile skin conditions such as Toxic Epidermal Necrolysis (TEN) and Stevens-Johnson Syndrome often cannot tolerate adhesives or prolonged facial pressure. For these patients, conventional tube holders may contribute to additional tissue injury. The HORSESHOE’s off-the-face design minimizes skin contact, reducing the risk of adhesive-related trauma and pressure injuries.

The device also addresses challenges encountered in patients with excessive moisture. Diaphoretic patients, as well as those with heavy secretions, often experience adhesive failure because traditional stabilizers rely on dry, intact skin. Similarly, patients with facial edema or fluid shifts can experience changes in facial anatomy that make securement increasingly unreliable over time. Because the HORSESHOE secures within the mouth rather than on the skin, it remains effective regardless of sweating, swelling, or fluctuating facial contours. Its adjustable gliding track further accommodates ongoing anatomical changes during the course of care.

Patients with facial hair represent another common challenge. Bearded individuals and members of religious communities may not be appropriate candidates for shaving, yet facial hair often compromises adhesive performance. The HORSESHOE eliminates dependence on facial adhesion altogether, providing clinicians with a reliable alternative that respects both clinical and cultural considerations.

Neurologic and critical care patients may also benefit significantly. Individuals with traumatic brain injuries, stroke, or other neurologic conditions can develop jaw clenching and bruxism during prolonged ventilation. Conventional bite blocks often concentrate force on the front teeth and may not adequately protect the airway. The HORSESHOE’s posterior Molar Props distribute bite forces across the molars, helping protect the endotracheal tube while reducing the risk of dental and tongue injuries.

For patients requiring extended mechanical ventilation, including those with sepsis, ARDS, COPD exacerbations, or severe respiratory infections, maintaining oral hygiene is essential yet often difficult. The HORSESHOE creates a consistent 25 mm oral workspace, providing clinicians with improved access for suctioning, oral assessments, and hygiene without compromising tube security. Better oral access can simplify care and support infection prevention efforts.

Additional patient populations include emaciated patients with atypical facial anatomy, partially edentulous patients missing front teeth, and agitated or delirious patients at high risk for self-extubation. By requiring only one molar on each side for placement and offering supplemental stabilization options through its Backup Strap™, the HORSESHOE provides reliable securement where traditional approaches may struggle.

The HORSESHOE Is A Unique Solution To Address Even the Most Complex Airway Scenarios

For more information or an evaluation of the HORSESHOE airway security device, contact your local MED Alliance Group sales representative, call 888-891-1200 or email us.

MED Alliance Group is a medical device distributor that has been dedicated to meeting the needs of our clinical customers and manufacturing partners since 1998. We specialize in the sales, marketing, importation, logistics and distribution of innovative, high-quality and cost-effective products found in anesthesia and respiratory, blood and transfusion therapy, EMS and emergency room, interventional radiology and cath lab, iv and vascular, as well as NICU and PICU.

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