the best ETT securing methods and devices

Published

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???

Must say I agree with the previous poster on all points. Also, I like how with tape the tube can be secured slightly off center & moved with each re-tape to prevent gum breakdown.

Up Vote Up Vote ×

Do some of your units have you (nurses) do your own taping? I'm a new grad so just wondering, we have our RT's do the retaping, I think I would be so nervous doing it!

Up Vote Up Vote ×
Specializes in NICU.

Either our RTs will come re-tape or one RT and one RN will do it together.

Up Vote Up Vote ×
Specializes in Public Health.

Add me to the list of tapers. After working in the NICU for almost a year, I can't imagine securing ETTs or NTTs any other way. ETTs are rare to see anway, and are converted to a NTT if possible. Our taping method is kinda intense, but theoretically we should be able to pick the kid up by the tube and have it remain secure (not that I would ACTUALLY do this).

Like littleneoRN said, you can just measure from the first visible number, and if you do the taping right it generally lasts for a while.

Also, sometimes old-fashioned techniques can work better than new approaches. I think it would be better to ask them why they prefer the taping method. Maybe they've already tried different devices in the past and came to the conclusion that their method worked best. There's definitely research out there, so ask around and look for articles.

Up Vote Up Vote ×
Specializes in NICU, PICU, educator.

We've trialed several and we always go back to tape...it just holds up better. We use skin prep under it and retape as needed. We have used the neobars on the smaller kids because those are the ones that the attendings love to play move the tube with, but with the bigger kids we use white cloth tape.

Up Vote Up Vote ×
Add me to the list of tapers. After working in the NICU for almost a year, I can't imagine securing ETTs or NTTs any other way. ETTs are rare to see anway, and are converted to a NTT if possible. Our taping method is kinda intense, but theoretically we should be able to pick the kid up by the tube and have it remain secure (not that I would ACTUALLY do this).

Like littleneoRN said, you can just measure from the first visible number, and if you do the taping right it generally lasts for a while.

Also, sometimes old-fashioned techniques can work better than new approaches. I think it would be better to ask them why they prefer the taping method. Maybe they've already tried different devices in the past and came to the conclusion that their method worked best. There's definitely research out there, so ask around and look for articles.

just a question...kind of off topic but I was wondering, are there advantages/disadvantages to having an ETT vs NTT? I am new but I have never seen a kid at my hospital with a NTT...maybe something I have to ask about on my unit if there is a specific reason we don't use them

Up Vote Up Vote ×

We only use NTT for our older (usually chronic) population - probably at least 6-8mos old. I think the cardiac ICU at our hospital almost exclusively uses NTT.

Up Vote Up Vote ×

Hi,

The thing what freaks me out that in our unit we dont use nothing for skin protection under the tapes - i know it sounds extreme and impossiblefor nowdays.. so thats why i m trying to find out of more how to secure, wich tapes to use, wich devices to try, and how to protec the poor baby skin..And as well i just wanted ask is there are special way of how to type the tape for securing the tape..does anybody still stich the ETT?

Up Vote Up Vote ×
Specializes in NICU.

We have been using neobars for the past 2.5 years and I love them! We have much less palate grooving with our long term intubated kids, no incidence of lip breakdown, and only a handful of cases with skin irritation (no tearing/sores however). Our extubation rate was slightly higher for the first few months of the trial but now we haven't had an accidental extubation in over 8 months. The neobars can stay on longer than 7 days and we only routinely change them if the sides are loose or soiled from emesis. Repositioning tubes is much easier for us as well as the baby because you only need to adjust the actual tape attached to the neobar ledge and ETT. No tearing tape off of cheeks when your CXR comes back with a high/low tube after a fresh tape job! I was very skeptical when we first made the change but now I can't imagine going back to taping. It just seems so messy, slobbery, and unstable compared to our neobar babies.

Up Vote Up Vote ×
Specializes in NICU, Post-partum.
We are trialing the Neo-Bar. Try googling that and see what you get. I bet that tape alone is the most common method.

We have been using the Neobar for years and it works very well, however, there are some things that are important to remember:

1. Fully expect to have to replace the Neobar within 24 hours of birth, because of the fact that these infants are slick and are generally not bathed prior to intubation...we wait until they are more stable.

2. Infants in high humidity environments or lots of oral secretions will need it replaced more often because it will come loose or just get nasty enough to need replacing.

3. Nurses on our unit are not permitted to change the Neobar without another nurse or RT by the side...this is to prevent unplanned extubation by sheer accident....we only have so many hands.

4. Nurses have to be very, very aware that the tape or Neobar is not putting the infant...nothing worse than to walk by and see a cheek getting pulled.

Up Vote Up Vote ×
+ Join the Discussion