The need to reduce ventilator associated events is the primary reason the Shiley evac oral endotracheal tube with TaperGuard cuff is critical for all patients on a ventilator in the ICU. Subglottic secretion drainage (SSD) helps remove oral and/or gastric secretions from above the endotracheal tube cuff before they can be aspirated. Such aspirations may lead to a very serious complication known as VAP or Ventilator Associated Pneumonia. SSD must be done with a specialized endotracheal tube with a separate dorsal suction lumen located just above the cuff.