ETT Tube feedback- Looking for input!

essT · Jul 21, 2015

We use tape (over a layer of Duoderm for protection). We see quite a bit of skin breakdown on the tiny ones but have no other options available at this point.

morgan_porgan · Jul 22, 2015

I have used both Neobar and Neofits. My previous hospital used the Neobar, I felt that sometimes it was hard to change out and didn't stick to the patient's face that well.

My new hospital just switched to Neofits, which I really do not like and not many of the nurses I work with like either. There is too much play towards the center of the mouth because it does not stick directly to the patient's skin in this area. This isn't a huge issue for the bigger babies, but for micro preemies or even babies less then 32 weeks, this can mean the difference between intubation and unplanned extubation. Also, when used with ETT less then 2.5, you have to move the "teeth" in order for them to grip the ETT. We were not educated about this when first issued these and this resulted in an unplanned extubation on a 23 weeker. I do feel that the ends stick nicely to the patients skin and the lollipops held to hold this in place.

I haven't used tape, but from what other coworkers have said, they prefer tape to any other method. They said tape is much more secure, but the only problem with tape is skin breakdown especially on the smaller patients.

FlyingScot, RN · Jul 22, 2015

I started taking care of neonates when the pre-cursor to the current ETT holders were in use. They were metal arches called Logan Bows. I hated them then and I'm seriously underimpressed with the more modern version. Neither held the tube very securely and the bar often acted as a fulcrum even when used correctly. I much prefer tape and Duoderm. My favorite tape is Elastoplast. It is stretchy enough to conform to the contours of the face but holds really well without destroying the skin. The downside of tape in my experience was the formation of palatal grooves but that was before surfactant and NCPAP (that actually works) so we'd have babies tubed forever!

NICURN29 · Jul 25, 2015

We use Neobars. I think they are fantastic. They have cut down on our self-extubations and have allowed us to stop nasally intubating babies...which is what we used to go for our teeny-tinies.