Palate protection with vented babies?

SheaTabRN · Sep 30, 2003

How ever do you come up with this stuff?!?!?! We don't use this, but I wish we would. I will show this around. Thanks for keeping us abreast Kristi!

Tab

NICU_Nurse, BSN, RN · Oct 1, 2003

Thank the internet.

I guess I just get frustrated when I see things happening as a direct result of our care, and just start looking for answers. It happens that the internet is a fabulous resource, but we all know that already! I mean, you see palate molding, and you read that these babies have issues later because of long-term vent-related palate molding, and I just think, "Man, there must be SOMETHING out there for that!" and then I hit Google. Thank you all for indulging me.

iceNICUnurse · Oct 1, 2003

I have never seen this!

Is this for babies that are intubated oraly or nasaly?

I culd not quite get how it is used...stupid me!

NICU_Nurse, BSN, RN · Oct 1, 2003

It's for oral intubation. The shovel-like part at the end (I'm assuming this is flexible- silicone maybe?) fits against the hard palate, on top of the ETT tube so the tube can't burrow into the gum line and hard palate (ever seen grooves on a long-term vented baby?).

And you're not stupid! They should have a picture of it in use. Blame them, not you. :) I don't ever want to hear that again in this forum, you hear me?

iceNICUnurse · Oct 1, 2003

Ok Ok I am not stupid Sorry!

We never have the kiddos intubated orally for more than a few days so we dont have this problem.

The only ones that are intubated orally are the ones anestesia intubates for surgery and we totally hate it when they do that. I am so scared that the tube will come out it feels so loose!

Thanks so much for the information !

NicuGal, MSN, RN · Oct 1, 2003

I've never seen them. I'm sure we wouldn't get those...way too expensive I am sure! When we retape the tubes we move them from sides of mouth to mid to sides.

NICU_Nurse, BSN, RN · Oct 2, 2003

I think they're about 30$/per protector.

prmenrs, RN · Oct 2, 2003

Yeah, expensive initially, but I'm spending (well, actually, me, my mother and the insurance co) ~$7000 getting my former premie son's teeth straightened--and that included having 8 teeth pulled so that they could straighten them. I thnk that palatte protector is a great idea, but when I suggested it years ago, I didn't get anywhere w/the docs.

Glad it's available now. Also glad there are not that many babes on long term ventilation.

kids · Oct 3, 2003

Also glad it is available, but I will be ecstatic when its use becomes SOP for tubed babies.

I have seen so many babies take forever to transition to oral feeds because because of palate deformations.

Just anecdotal but my grandson was intubated for most of 10 days, his top 2 front teeth are just now coming in, the ones to the outside of them came in a couple of weeks ago (are coming in in the wrong order).

NICU_Nurse, BSN, RN · Oct 3, 2003

Medline has a bunch of articles regarding this, but I honestly don't know (ie, haven't taken the time!) how to get access to anything other than the abstracts.

I readily admit that I know very little about costs related to the NICU, other than general figures (ie, so many thousands of dollars for so many months stay). To me, though, $30/per doesn't seem too expensive, especially considering that the average length of intubation for most neonates is somewhere between 10 and 20 days.

I wonder how long you can use one before it becomes too small and has to be changed? Is there a risk for oral bacteria accumulating under the protector between it and the palate? Can you insert one *after* emergency intubation (ie, slide it on top of the ETT) or does it have to be applied before you intubate? Lots of questions. :)

I think it's an interesting product, though, with a very relevant theory behind it. At least someone's making an effort! If we ever get our hands on some of these, I'll let you know.

Mimi2RN, ASN, RN · Oct 4, 2003

I haven't seen them in use, but our local Level III was using something like that a few years ago. They were a product of co-operation between an orthodontist and a neonateologist. I have no idea if they are still using them, it seemed to me to be such a good idea.