- 0Feb 9 by birdieshotI am just wondering what everyone is using for keeping their ET tubes secure, especially with infants. We are still using white sticky tape, with benzoine under the tape to keep secure. As we know with RSV secretions, it still gets extremely loose, and spending more time re-taping ET tubes.
So just curious if others are utilizing devices out there, and if one is better than another?
- 1Tape. We usually put a layer of Duoderm ExtraThin underneath it. No benzoin... we use Mastisol. It goes underneath and on top of the Duoderm and part way up the ETT, then the tape goes on top of it. But then 99.9% of our ETTs are nasal...
- 0meanmaryjean, nasal intubation does increase the risk of VAP quite significantly. But all of our intubating physicians prefer the nasal route, so all residents are required to learn the technique. As for commercial holders, we might occasionally see them in older patients who have been tubed elsewhere, but our RTs will take them off and replace them with tape at the first opportunity. Makes extubation of older males a real good time!
- 0Feb 11 by WoosahRNPart of our VAP protocol is for oral intubation. Obviously if there was a specific surgery or difficult intubation and it ended up being nasal, that's different.
Not sure what that brown stretchy tape is but that's what our RTs use along with mastisol. That white tape does lose it's stick pretty easily. We retape if we get a kid from OR or outside facility with that stuff.
- 0Feb 11 by NotReady4PrimeTime Senior ModeratorOur VAP protocol very deliberately avoids mention of tube route. We're all about the 45° HOB elevation and the "tubing draining away from the patient", as one of our intensivists reiterates at the end of his review of rounds as part of his QI mantra. Not that I disagree with those measures, but I really fell that if we're going to use bundles we shouldn't be picking and choosing the parts of the bundles we follow. Between nursing these kids sitting up, turning and cleaning out their mouths q2h and the noise around them 24/7 we have to use a barrel of sedation to keep them intubated.
That Elastoplast tape is AWFUL for taping ETTs. It stretches and stretches then the tube trombones, the kid coughs and gags like nobody's business and we end up changing it.