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.
Oh no! That's what we've been using for 20 years! Why do people not like it? We put duoderm underneath - never have had a problem with unplanned extubations.
Oh no! That's what we've been using for 20 years! Why do people not like it? We put duoderm underneath - never have had a problem with unplanned extubations.
I think the problem with it is that it is elastic. When some folks tape the tube, they stretch the tape ever so much and apply it to the patient. Then, over time, the tape contracts and loosens it's seal and become less or uneffective.
Non elastic (silk/cloth) tape is so reliable, but I think Neo-bar type devices are the best, especially when used with duo-derm.
Im not sure how standard this practice is, but where I worked, ETT tape got changed every 72 hours whether it looked like it needed it or not. Usually it did by that point, or sooner. But I think it made people less likely to wait "too long" to do it....since it had to be done anyway.
My unit uses Caviprep wipes as a skin prep adhesive, and secures the tube with a white mesh 3M micropore tape. Can't for the life of me find an actual name for it online, but we switched from regular old cloth tape and our RRTs like it better. It does have some stretch to it, but everyone is aware of it and it hasn't posed any issues for us. Luckily we don't see a whole lot of unplanned extinctions on our unit (knocks wood!)
The 3M tape you are referring to is Multipore Dry. It's on a liner and has a fair amount of stretch. It's very important to not stretch it when it's applied and to use firm pressure after application especially where there is any over-taping. Spiraling up the ET tube is best vs a lot of tape over tape. Also giving the ET tube a firm squeeze where there is any tape to maximize adhesion.
Positioning has been a non-issue with the amazing Z-flo brand fluidized positioners. The "fish-hook" look is awful and can cause permanent damage to the facial tissues, hopefully that's never occurring!
Chare - Yes, obviously we have looked at all angles of potential causes. I was focusing on HELPFUL tape/skin prep protocols because we split the members of our UBPC to focus on different angles of the issue. Thanks.
rnkaytee
219 Posts
Oh no! That's what we've been using for 20 years! Why do people not like it? We put duoderm underneath - never have had a problem with unplanned extubations.