UC Davis Engineers Develop Medical Device to Better Protect Babies on Ventilators
In the NICU, critically ill babies rely on an endotracheal tube to breathe, but keeping it in place comes down to a strip of tape.
As part of their senior design project, five biomedical engineering students at the University of California, Davis, developed First Bite, a medical device that includes headgear and an external guard with a built-in adjustable cable to hold the endotracheal tube in place.
“We’ve gone through different iterations of how we want to figure out a good solution to this problem,” says co-founder Rachel Amstutz. “The entire time we’ve been sticking to a non-adhesive option because that is one of the primary problems with the methods they’re using currently, which is tape.”
The tape method presents challenges for both the infant and the clinician. It can last for as little as six hours. Doctors have to keep re-taping throughout the day, which can damage fragile skin and lead to infection. In humid conditions, the tape might come loose, dislodging the tube and potentially leading to serious complications. These vulnerable patients also need to be medicated every time they’re re-taped.
Amstutz says First Bite improves tube security, allows for easier tube depth adjustment and lasts about three or four days before it needs to be replaced, reducing the time clinicians spend on changes.
“One of the big challenges we’ve had is designing for a range of ages, from the NICU through the PICU, because NICU babies can be so, so tiny,” Amstutz says. “It’s hard to find a device that is light enough for them that it won’t cause pressure injuries on their skin. But it also has to fit as they go through different fluid changes in head shape, and they need to be repositioned. So it’s really about designing something that can accommodate a lot of small changes that happen frequently in that population.”
First Bite has performed well on the competition circuit, placing third in the Sacramento Kings Capitalize competition, and recently won the $25,000 first-place prize at the 2026 Big Bang! Competition.
Dr. Benjamin Wang, the team’s advisor and a UC Davis alum, has a track record that serves First Bite well. Wang won first place at the 2014 Big Bang! Competition with a breathing tube to prevent bacterial infections in ventilated patients.
Every year, vulnerable children need to be put on a ventilator for various life-critical reasons. “For many of them,” Wang says, “it will be the most dangerous period of their lives and the most emotionally taxing time for their parents.”
When the placement of a life-sustaining breathing tube is a matter of millimeters, every tiny decision can affect a child’s outcome.
“As any person who works with children in the ICU will tell you,” he says, “this is a dreaded problem that clinicians go to great lengths to prevent and which still continues to plague children’s hospitals all around the world.”
While big companies may see the issue as a way for hospitals to procure multimillion dollar monitoring systems, he says, the First Bite team sees an opportunity to create a low-cost, easy-to-use device to eliminate the issue of unplanned breathing tube movement.
A big part of their success, he says, comes from a willingness to work with and receive feedback from clinicians who handle these tubes daily: UC Davis neonatologists, emergency room physicians, anesthesiologists, respiratory care therapists and nurses.
These conversations helped the team refine their design. According to Amstutz, clinicians don’t like any of the headgear options on the market.
“A lot of devices slip off the child’s head,” she says. “These NICU and PICU patients move a lot more than you would anticipate, so even just rubbing their head on the bed can change where the device is sitting. They also wanted it to be highly adjustable for a range of head sizes. … We originally didn’t have any space for oral care, then we realized we needed to make room for that.”
The team graduated this spring, but they’re still working to push the device beyond a class project. Currently, they’re in talks with a manufacturer overseas and planning to make a finalized version of the prototype to get molds designed in the fall.
