annag

Hello all! I am a neonatologist, working at the Karolinska University Hospital in Stockholm. We reviewed our ETT fixation strategies during 2017-2019 in a Quality Improvement Project. We generally nasally intubate our infants, from week 22-term infants. We looked at devices, and were especially interested in the NeoBAR, NeoFit and an attractive method used in England with a clip (can´t recall just now what it was called) but all these were more suitable for oral ETT. After this ploughing of the market for devices and tapes, we decided that improving our taping technique with a new tape sort was the optimal choice. In fact, it was a disappointment how few fixation methods/devices are available and how little interest the companies we contacted had in helping us. When we decided on our standardized taping method we focused on a "one fits all" method, as we have many co-workers that need to learn the method, furthermore we focused on "less tape is more" with the amount of tape. Our standardized methods are shown in the links, that Stefan already shared with you (see above). We have followed our unplanned extubation rate which has decreased significantly after implementation and we also follow the rate of skin contusions/ulcerations due to taping. It would be very interesting to here more thoughts on taping techniques and devices suitable, especially for nasla ETT. Thank you for starting this chat and for letting us att Karolinska share our experiences. best regards Anna