the best ETT securing methods and devices

karnicurnc, MSN, APRN, CNS · Mar 12, 2010

We are trialing the Neo-Bar. Try googling that and see what you get. I bet that tape alone is the most common method.

NJNICUCCRN · Mar 12, 2010

We just use tape in our unit. I have worked in 2 nicus and we have trialed about 3-4 different methods but always come back to tape. If we could get together and come up with something that really works, we'd be able to retire :)

ittybabyRN, RN · Mar 12, 2010

Just tape over here

NICU_babyRN, BSN, RN · Mar 12, 2010

We use a tape method but also use neobars on some patients. it depends on how active the patient is. More active patients do better with tape. Our well sedated, quiet patients do well with neo-bars

ligucis21 · Mar 12, 2010

thanksto everyody!!! i am aslo trying to find more info about the ways how to tape it..and as well what kind of types to use? and what about the skin protection under it???

Cindy Lee · Mar 12, 2010

We also use the neo-bar with good success for oral intubations. For nasal intubations we cut a 2 inch piece of feeding tube, run a suture through the middle of it and cut off the needle. Once the baby is intubated to the correct depth, place the piece of tubing across the upper lip and tie the suture around the ETT (snuggly but not occluding the ETT) The tube can not slip in deeper now.We circle the ETT with tape and run the edge over the piece of feeding tube. We then apply adhesive gel and tape over the piece of feeding tube and then bridge tape over the nose. Is that clear as mud? :rolleyes:

NebraskaRN · Mar 13, 2010

We use cord clamps that have a hole in them for the ETT and tape to the clamp with "pink" tape, under the pink tape we use tegaderm as a barrier to the skin

jlb_rn · Mar 15, 2010

The majority of the time, we use tape; kiddos with a ton of secretions will sometimes get a neobar. Personally, I prefer tape for no reason other than that's my comfort level. Whenever I take care of a kiddo with a neobar, I'm amazed at how much of the tube is visible and I feel like it's going to come off / out. :)

For securing taped tubes, we use duoderm on the cheeks, mastisol (>30d) on the duoderm, upper lip and in between each piece of tape and secure the tube itself with 3 pieces of "Y" shaped tape in opposition candy-caned up the tube as well as being secured ear to ear. We use the white opaque surgical tape.

littleneoRN · Mar 15, 2010

Hi, to everybody! i am kind of new nurse in NICU. but more or less i am so suprissed of the way how the ETtubesare fixed in our unit - only tape and not even a try for some newstyle fixing device..is there are advices how to talk those " old fashioned" nurses into using devices? wich websites would be the best to gain some information? and what kind of ETT fixing are the mot common???

I'm a newbie too, but I guess I don't understand the big push to use a new device. We mainly use tape, which is inexpensive and more secure than our other options. We have relatively infrequent inadvertent extubations despite a pretty liberal policy on holding...eg totally encourage kangarooing on any stable vented baby. Is there a reason why you want to push for devices? Just curious.

NICU_babyRN, BSN, RN · Mar 15, 2010

I'm a newbie too, but I guess I don't understand the big push to use a new device. We mainly use tape, which is inexpensive and more secure than our other options. We have relatively infrequent inadvertent extubations despite a pretty liberal policy on holding...eg totally encourage kangarooing on any stable vented baby. Is there a reason why you want to push for devices? Just curious.

Neobars can stay in place for 7 days, sometimes longer. Tape is more labor intensive and each time you have to retape you can tear skin even if you have duoderm on the skin.

The neo-bar also allows for ease of seeing at what cm marking the tube is secured at.

littleneoRN · Mar 17, 2010

Do you find a need to replace your tapes more often than every 7 days? Just curious. I don't feel like we retape very often--I definitely wouldn't guess every 7 days. There is definitely a concern with skin tears with tape. I'm not real familiar with the neobars---do they not tear skin like tape?

I guess tape is labor intensive, but for us it's secure, effective, inexpensive...so the five minutes of cutting and taping seems like not a big deal. Sometimes the number is covered by the tape, but often we can see it if we look from the side, or we measure down the tube from the closest visible marking.

Just my thoughts.