Hi all:

Any one using Mastisol to secure the ETT? We've had couple of incidents were it looked like "chemical burns" may be because of the a bit too much of Mastisol.

So what is the census here ? Do you use it or not ?

or we can make up another question:

How do you secure ETT esp. in VLBW? Do you use any liquid adhesive?, if yes , what kind?

Until a couple years ago we used to use Mastisol to secure every ETT. Since then it has been removed from our unit (well it is still there if you know where but very rarely used) due to chemical burns and skin abrasions with extubation especially in the ELBW and VLBW population. Currently we just clean (Sterile Water)/dry the area where we tape the ETT and have not noticed an increase in accidental extubations. It appears to me though that we have to re-tape our ETTs a little more frequent since the removal of Mastisol but we rarely see skin issues anymore.

I have seen the use of Mastisol virtually stopped in the NICUs I have been in for the last 20 years due to the risk of neonates skin absorbtion of harmful chemicals and skin injury. There are some diehards who will keep a contraband hidden supply in one NICU I observed. The use of NeoBars has reduced the use of tape on the skin and skin irritation and injury. Just as with ant taped ETT, NeoBars have to be monitored for security and changed as needed. I haven't seen ETTs taped for years. Hated the NeoBars at first as with anything new and learning curves, have loved them for years.

We have mastisol in our unit but are discouraged to use it especially in the preterm. We use the neobars and/or duoderm to protect and adhere to the skin.

We are also usingNeobars with Cavilon skin prep. works very well.

We stopped using Mastisol a few years ago and we have never used the NeoBars, which I have used at other facilities.

We use a bone (Which is actually an umbi clamp that has a hole drilled through the middle. The holes are individually drilled to match ETT size). This is clamped onto the ETT. We use Cavilon (which we love) on the cheeks, followed by a layer of Replicare, then a piece of cloth tape on each side. The cloth is cut like a "Y" and the top end wraps around the tube while the bottom end wraps around the bone, and we aim for a "fish lip", or for the lips to be puckered. It works fantastically and our accidental extubation rate is low.

We stopped using Mastisol a few years ago and we have never used the NeoBars, which I have used at other facilities.

We use a bone (Which is actually an umbi clamp that has a hole drilled through the middle. The holes are individually drilled to match ETT size). This is clamped onto the ETT. We use Cavilon (which we love) on the cheeks, followed by a layer of Replicare, then a piece of cloth tape on each side. The cloth is cut like a "Y" and the top end wraps around the tube while the bottom end wraps around the bone, and we aim for a "fish lip", or for the lips to be puckered. It works fantastically and our accidental extubation rate is low.

Hello Marim,

can you post a picture if it doesn't breach patient's right?

Visual will be best to remember

Is it possiblble for you of actual procedure with plcture of securing ET. Fixation

DINESH

we occasional use mastisol but very rare, our ett tubes come with holders that do secure to the face, and above and below the lip, we have used logans bows and tape, neobars, but the ones that come with the ett tubes tend to work the best for us.

we occasional use mastisol but very rare, our ett tubes come with holders that do secure to the face, and above and below the lip, we have used logans bows and tape, neobars, but the ones that come with the ett tubes tend to work the best for us.

 

What manufacturer do you get your ET-ttubes from? The holder seems interesting for us.

• We use duoderm applied to either side of the cheek close to the alae nasi and the angle of mouth . Then the tapes wound around the ETT are fixed on to the duoderm . We havent found a problem with duoderm and apparently is soft on the neonatal skin . This has worked well so far and presumably safer than other options , I would imagine '

Thanks

Gopan