Jump to content

JOIN THE DISCUSSION!

Want to join the discussions?

Sign up for a free membership! 

If you are a member already, log in!

(lost your password? reset it here)

99nicu.org 99nicu.org
NRao

ET tube fixation methods

Recommended Posts

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites
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 :) 

Share this post


Link to post
Share on other sites

That would be great! Thanks a ton


Sent from my iPhone using Tapatalk

Share this post


Link to post
Share on other sites

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.

  • Like 1

Share this post


Link to post
Share on other sites

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.

  • Like 1

Share this post


Link to post
Share on other sites

We use Neobars. When the baby is in heat and humidity, they tend not to work as well. On occasions we some time add Tegaderms for additional support.

Share this post


Link to post
Share on other sites

Dear all, Karolinska University Hospital has published their tube taping practise on Youtube. 

@Karolinska and Anna Gudmundsdottir - thanks so much for sharing!

Nasal tube fixation

 

Oral tube fixation

 

 

  • Like 1

Share this post


Link to post
Share on other sites
49 minutes ago, Stefan Johansson said:
Dear all, Karolinska University Hospital has published their tube taping practise on Youtube. 
@Karolinska and Anna Gudmundsdottir - thanks so much for sharing!
Nasal tube fixation

 
 


Thank you! With practice drifting towards resuscitating 22w onwards, I wonder what would be the choice of securing device? Given that we would be using size 2 ETT and NEO-FIT is not recommended.


Sent from my iPhone using Tapatalk

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×
×
  • Create New...