ET tube fixation methods

[Narasimha Rao]

I’m trying to identify a good fool proof method of securing ET tube and there doesn’t seem to be a consensus.

 

I’d like to hear what methods do you all use on your units and if you could share any thoughts, experiences and ideas here please.

 

 

Sent from my iPhone using Tapatalk

[Guest darlene3630]

We use Neobars and find they work well.

[rehman_naveed]

We use nasal intubation to have stability, fixation is usual with tape 

[Narasimha Rao]

I am reviewing our current methods and we have a choice between non-adhesive tape, neo-bar, neo-fix and the clip.

I wondered if there had been any local/ regional audits looking at safety (unplanned extubations), skin and tissue viability issues, MRI compatibility, infection control etc.

Appreciate all your inputs.


Sent from my iPhone using Tapatalk

[Stefan Johansson]

We utse the Neo-fit tube grip. Works well!

https://www.coopersurgical.com/medical-devices/detail/neo-fit-neonatal-endotracheal-tube-grip

[Narasimha Rao]

We utse the Neo-fit tube grip. Works well!
https://www.coopersurgical.com/medical-devices/detail/neo-fit-neonatal-endotracheal-tube-grip

Thanks Stefan. I’ve been considering this too.


Sent from my iPhone using Tapatalk

[Stefan Johansson]

24 minutes ago, NRao said:

Thanks Stefan. I’ve been considering this too.

I got the advice on this device some years ago from a US-based RT. It is very easy to adjust the tube position as the tube is secured with velcro over metal "nabs". Don't know if it MR-safe though (manufacturer would know).

For smaller preterms (like <1000g) the "tape plates" are too big. And care in high incubator humidity works less well, the tape gets loose. But overall and especially for term infants needing short-term invasive ventilation, this device works really well IMHO.

The Karolinska level-3 NICU use tape in a new fashion, I think there is a video clip on Vimeo - will check out next week at work if I can share it here  

[Narasimha Rao]

That would be great! Thanks a ton


Sent from my iPhone using Tapatalk

[JPinheiro]

I agree with Stefan. With size 2.5 ETTs, the Neofit plates are difficult to tighten "just right". They are often too loose and let the ETT slide, or, if tightened more, they can crimp the ETT and impede passage of a suction catheter. Otherwise, the device works fairly well. We have also tried Neobar, and used modified cord clamps for years. There is no evidence of a clear advantage of any particular system, and our experience doesn't point to a clearly superior method, either. We think we might have had less unplanned extubations with the locally modified cord clamps, but we didn't rigorously track unplanned extubation rates back then, so we really don't know.

[Petri Mansvelt]

The NICU`s in the Netherlands al secure tubes with tape. It only differs in detail and in the type of tape.

At the last NICU congres in Copenhagen there was a poster from Sweden about the tape fixation.