OGT securement in intubated patients

[JeffTheRN]

We usually, as a standard, tape the OGT to the ETT (still being able to visualize cm markers and tube size markers etc...).

Anesthesia, now, does not want anything taped directly to the ETT.

My question for everyone is, what is your standard for securing OGT's in intubated patients?

[Pinky89]

We tape ours to the ETT securement device, not the actual ETT.

[essT]

We secure to the cheek with tegaderm. Apparently there was an accidental extubation caused by a patient pulling out their OGT and the ETT coming with.

[delphine22]

Tape to ETT. I always try to do a chest-tube-style tape, meaning I fold down the two free ends of the tape so it's easy to take off if necessary.

[icuRNmaggie, BSN, RN]

Mark OGT with a sharpie post PCXR to monitor placement ATL and secure with tabbed silk tape so that both tubes are rotated side to side.

You can also add another movable clamp to the Hollister ETAD and use it to secure an OGT , Linton, Minnesota or Blakemore tube.

[ashleigh_0804]

Usually after anesthesia intubates a patient, we never hear from them again, so I don't k ow their opinion on it. Now, our RTs sometimes complain if we don't leave a 'courtesy' flap or cover up markings. A courtesy flap (in case you don't know) is when instead of fastening the last end of the tape to the ETT, you double back a little piece. This makes it so you can easily take it off. I can't see why they would ever care, except for if you don't leave this flap and you can't take the tape off, so it can't be repositioned. Our hospital doesn't have a policy.

[Rebecca Carter]

I too am use to securing to ETT as I feel it is more secure and less able to slide out of place or be tongued out of place by patients. When anesthesia has these patients, they ARE NOT AWAKE!. Therefore, they are not dealing with placing meds down an ETT that may or may not have moved because it has curled or looped in the patient's mouth or been tongued forward by restless patients. We did have an incident years ago where a patient self extubated by grapping the feeding tube which was within his reach. RTs answer was to ban taping of the ETT despite the fact that the in-line suction devices are as much a danger for the patient to wiggle down in the bed and grab. So, they made that an "unofficial policy as part of their action plan. Of course anesthesia agreed because that is what they are also use to. Regardless, the nurse has to use this OGT for meds in alot of cases and cannot be 100% assured that it has stayed in place since the last xray. Also, there are only suggestions as to how to secure to the face, not a policy or manufactured device. So, some are taped, some with op-site and some with NGT holder devices. None of these keep the OGT secured as well as taping to ETT. Sometimes these are barely staying secured to the face and are half way off when I enter the room due to sweat or beard stubble. The policy should be how to keep the OGT secured above the shoulders so pt"s can't grab at it or the inline suction catheter that I frequently find sitting on the pt's chest. That is the real problem!

[Rebecca Carter]

I would love to know of a manufactured OGT securement device for intubated patients. Anybody know of one?