Pediatric Chest Tube Securement Devices

[nterenzoni]

Hello,

I am currently researching new devices to be used to secure chest tubes to the patient. Right now the practice is to secure the chest tube using a safety pin to either the patient's diaper or their bed, but have had a couple get pulled out in the past year. We are looking for a device such as grip-lok or stat-lock that holds the chest tube in place and will reduce its displacement in neonatal and pediatric populations. Also looking for something that doesnt cause skin breakdown- what are other hospitals using and what works/ what do people like?

Thanks,

Nicole

[Esme12, ASN, BSN, RN]

thread moved for best response

[NicuGal, MSN, RN]

I haven't seen any stat locks for chest tubes. We still tape and pin in several places.

[nterenzoni]

Yea, unfortunately we have had a few get pulled out in our NICU patients as a result of the tape and pin so trying to implement something a little more secure and safer.

[NicuGal, MSN, RN]

I did a google and there are stat locks for all kind of tubes, but the problem may lay in that they don't make them small enough and the cost may be prohibitive ( at least where I work it would be, we are a county hospital.).

When are your tubes coming out? We suture them with a purse string, chevron steri-strips and cover with an occlusive dressing. We then chevron again for stability and then pin.

[Sloan RN]

I've used a dressing with a securement component similar to this: Percutaneous Drainage Catheter Fastener and it was awesome. That's not the exact dressing, but it's close. The downside is that the doc who placed it didn't suture it in because of the securement device, but the securement device is actually part of the dressing and comes off when you do dressing changes. A dressing like this + sutures would be perfect IMO.

[umcRN, BSN, RN]

Interesting. We don't use and securing devices nor do we safety pin and I've never seen one come out. They are sutured in and dressed with an occlusive dressing. If kids are getting up and walking then we might use plastic clamps to secure them to the c!others/gowns but that's it.

[NotReady4PrimeTime, RN]

We don't pin our chest tubes to clothing either. A strip of FlexiTrak is stuck to the kid's abdomen/chest to take some of the tension. We do (and not by choice!) wrap a piece of waterproof tape around the collection tubing and clamp it to the bed with a Kelly. Creates major problems when the kids start moving around. But it's a non-negotiable MUST with one of our CV surgeons. I've had him berate me in front of others within minutes of the kids coming back, "Are you going to secure that tube to the bed?"

[PRNketamine7, BSN, RN]

We also use a rubber band and safety pin on the bed sheets. and to keep the chest tube connected to the drainage system tubing we use a gun and tie.