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How do you tape the ET tubes?!


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Guest bstorey531

We too were using a safety pins and tape to secure our ETT's, but have recently gone to the Portex tube holders. It's about 50/50 on the reviews but we're continuing to use them and trying to perfect their use. You can move the tube easily if it's not in the right place without a pin hole or extra pins in the tube.

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  • 2 weeks later...

Hi, we use the portex tube with flange. A recurring debate is cutting a slightly longer tube and clipping the flange on the tube thus allowing the user to advance/pull the tube if it is found to be too short/long on CXR and so avoiding reintubation. Does it hold the tube adequately without reducing the internal diameter? Any other suggestions for ETT that you can alter the length in situ greatly appreciated.

Regards

Al

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  • 4 weeks later...

we fix the ET tube with a dynaplast ( an adhesive tape). To prevent injury to the skin, we first stick tegaderm on the upper lip and over it fix the dynaplast. The dynaplast is cut in a 'H' fashion. one limb of 'H' is fixed on the upper lip and wings of the other limb is on the ET tube. It works well and there is no damage to the skin. Even ELBW babies tolerate it well

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  • 2 months later...
Has anyone used NeoBar? I've tried it on a few babies and seems to work well. A caveat is that using pre-cut tubes may result in the tube being too short.

We use the Neobar in our unit. We have had good luck with this product as long as they are secured properly. Make sure the size is correct prior to securing to the baby's face. The Neobar does allow for some flexability with the family's ability to hold their baby.

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We also use the neobar for our orally intubated patients, but most of our kids are nasally intubated! Then, we have a verry unique technique. The pictures with an short explanation can be downloaded here....http://www.intensivmedicus.de/downloads/Tubusfixation.pdf

It requires some training, but it´s almost bomb proof :)

Please note, the pictures are of old origin and not optimal. They show a white tape on the left cheek that has been placed is too low on the baby´s lips.... For ELBW´s we usually use Tegaderm under the brown tape to protect the vulnerable skin....The explanations given are in german language, if somebody wants them in english, please feel free to email me privately

Regards Norbert

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  • 2 months later...

HI..........

We used to use a ETT system that came packaged with a mask ( shaped like a stretched out x) that had a built in lock system. Each mask was specific for that size of ETT it was packaged with. We had good results with this system, except for in the tiny micro premies (it was just too big to adhere in the appropriate way) and with very "slimy" babies with lots of secretions. This type was fairly easy to apply and made placement adjustments quite simple.

Recently we switched to the NeoBars. We are still getting used to them but have been advised that selecting the correct size is essential. The bar adheres to the baby's face much farther back on the jaw and is therefore more appropriate for tiny babies and avoids the oral secretion problem. There does seem to be a built in quantity of "play" in the position of the tube. (as the cheeks and facial skin can flex and allow the tube to pull out just a bit) This hasn't been a large problem for us except with the tiny babies where the difference of a half cm. can mean extubation. With larger babies, we just take care with positioning to keep the bar in a non-tugging position. With the exception of one particular baby who coughs up every tube we have put in him (going on 6 weeks of intubation and awaiting a trach!).....I believe our rate of unplanned extubation has dropped. I know our doctors are very supportive of the NeoBars.

Hope this info is helpful!

Spacey

(from NW Florida....USA)

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  • 2 years later...
Guest Neostudy
We also use the neobar for our orally intubated patients, but most of our kids are nasally intubated! Then, we have a verry unique technique. The pictures with an short explanation can be downloaded here....http://www.intensivmedicus.de/downloads/Tubusfixation.pdf

It requires some training, but it´s almost bomb proof :)

Please note, the pictures are of old origin and not optimal. They show a white tape on the left cheek that has been placed is too low on the baby´s lips.... For ELBW´s we usually use Tegaderm under the brown tape to protect the vulnerable skin....The explanations given are in german language, if somebody wants them in english, please feel free to email me privately

Are you still using the Neobar? If so, what are your thoughts on it?

Regards Norbert

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Guest Neostudy
We use the Neobar in our unit. We have had good luck with this product as long as they are secured properly. Make sure the size is correct prior to securing to the baby's face. The Neobar does allow for some flexability with the family's ability to hold their baby.

Are you still using the neobar? If so, what are your thoughts on it?

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  • 11 months later...

We use Potex ETT tubes with a Portex Tracheal Tube Holder manufactured by Smiths Medical International Ltd. CT21 6JL, UK. These come in different sizes as from 2.5mm ID to 4.5 mm D. We use oral intubation and the holders are effective, aesthetic in looks and most important they do not cause skin injury in these vulnerable infants.

V.Baichoo

Consultant Neonatologist

Corniche Hospital

Abu-Dhabi, U.A.E.

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  • 3 years later...
Guest khader

We use Neofit which can be used for both oral and nasal intubation, it is very easy to apply and if done correctly keeps the tube very secure. The other advantage is if on X-ray you need to re-adjust the tube could be done very easily. The web address will give you more information.

http://www.coopersurgical.com/ourproducts/Pages/NEOfitNeonatalEndotrachealTubeGrip.aspx?order1=42-2540&lc=Critical%20Care%20Products&name=NEO-fit™%20Neonatal%20Endotracheal%20Tube%20Grip&tc=1

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