NICU ETT tape

[alfollin1]

What brand/type of tape and/or skin prep do you use in your NICU?

I see past discussions about neobar vs. tape for securing ETT in the NICU. We use the neobar in my NICU currently but have been having accidental extubation increases and are reevaluating on our Unit based council. We used tape before but the tape we have now is not sticking well! We do not do any skin prep at this time. I'd really like to try that as well.

I see Mastiol as a common skin prep in the past discussions, when I went to the website there are different options such as mastiol vial, spray, unit dose or dispenser cap. Which are places using?

Elastplast tape is a reoccurring suggestion, there were so many types of those as well.

Any help/advice is much appreciated. Thank you!

[vanilla bean]

We currently use Mastisol plus cloth tape, but not all tapes are created equal. My facility changed medical suppliers a few years back and we had an increase in accidental extubations (in all patient populations) with the new tape, so now the RT department special orders cloth tape specifically to secure ETTs.

[TheCommuter, BSN, RN]

Moved to the NICU Nursing forum.

[essT]

We use duoderm as a skin barrier, elastoplast to hold the tube, and tegaderm over the top to keep the elastoplast from curling.

[offlabel]

I think, perhaps, if you are seeing a spike in accidental extubations, attention to the care and handling of intubated patients might be given at least as much attention to the kind of tape being used.

[NicuGal, MSN, RN]

When we changed vendors we noticed the tape didn't hold as well either.

We just switched to a new tape, I can't remember the name off the top of my head, but it reminds me of twill tape with a sticky back. It hold like nothing we have used before. We no longer have to use benzoin under it. I am on vacation, but will check it when I get back to work.

[NicuGal, MSN, RN]

I think, perhaps, if you are seeing a spike in accidental extubations, attention to the care and handling of intubated patients might be given at least as much attention to the kind of tape being used.

Not sure if you work in the Neonatal world, but unlike adults, we don't keep our patients sedated to the point of no movement, or use meds to decrease oral secretions. These kids do move and bubble secretions and the tape does loosen up and sometimes extubate ond occur...sometimes the tube slides they the tape. Certain tapes do hold better than others.

[offlabel]

Not sure if you work in the Neonatal world, but unlike adults, we don't keep our patients sedated to the point of no movement, or use meds to decrease oral secretions. These kids do move and bubble secretions and the tape does loosen up and sometimes extubate ond occur...sometimes the tube slides they the tape. Certain tapes do hold better than others.

Many moons ago I did PICU...forgot about that awake, unsedated state a lot of these kids are in...good point.

[chare]

Not sure if you work in the Neonatal world, but unlike adults, we don't keep our patients sedated to the point of no movement, or use meds to decrease oral secretions. These kids do move and bubble secretions and the tape does loosen up and sometimes extubate ond occur...sometimes the tube slides they the tape. Certain tapes do hold better than others.

I work a PICU where we frequently see neonates for a variety of reasons, and agree, to a point. However, in the setting of a recent increase in unplanned extubations:

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…We use the neobar in my NICU currently but have been having accidental extubation increases and are reevaluating on our Unit based council…

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I think that offlabel is spot on, and evaluating staff procedures should be at least as high a priority, if not higher, than mechanical issues.

[adventure_rn, MSN, NP]

Not sure if you work in the Neonatal world, but unlike adults, we don't keep our patients sedated to the point of no movement, or use meds to decrease oral secretions. These kids do move and bubble secretions and the tape does loosen up and sometimes extubate ond occur...sometimes the tube slides they the tape. Certain tapes do hold better than others.

So, in a similar vein to offlabel's train of thought, I wonder if you've considered how kids are positioned. One of my previous units had a big problem with unplanned extubations, and one of the most helpful factors in preventing extubations was to ensure that every kid was in a bendy bumper that was secured so the baby wouldn't slide down to the bottom of the bed. If the baby's head and body are relatively secure (i.e. with bendy bumpers and froggy bean bags), and the tube is relatively secure (i.e. with an angel frame), the ETT tape doesn't have to withstand much tension, as opposed to a baby who is rocking the 'hooked fish' look dangling from his ETT as he slides down the bed. I know that with gigantic, active term kids it might make less of a difference, but I think containment can be really beneficial with the tiny babies.

[meanmaryjean, DNP, RN]

Our NICU uses that awful pink/flesh colored plastic tape. Just about the first thing we do upon transfer to PICU is change to benzoin skin prep and cloth tape.

[offlabel]

Our NICU uses that awful pink/flesh colored plastic tape

that stuff should be outlawed.