Securing ET Tube

[MedEngineer]

Please pardon my ignorance on this subject, as I am trying to get up to speed. I am an Engineer working on a concept to help in the securing of the ET Tube. I see that the Neo Bar is a popular device. My understanding is that once the tube and device is in place, the tube is secured to the tab on the Neo Bar with tape. Is there room for improvement on this taping method? How often does the tube securing tape have to be removed and replaced, and how long does this take? Does the tube need to be repositioned often? Would a device that replaced tube securing tape be helpful? If you don't use the Neo Bar, what do you use to secure the tube, and are you hapy with it? Any comments or feedback would be greatly appreciated. Thanks!

[dawngloves, BSN, RN]

I would say with the Neobar, the tape does not need to be replaced that often because it is far from the baby's mouth and won't get secretions on it. If placed properly and secured well, the tube should not need to be moved but once after initial placement. That should only take but a minute.

My two cents about the Neobar, I think there is too much play with the bigger babies. As if their chubby cheeks cause the bar to move too much.

[NicuGal, MSN, RN]

I agree with the above comment on the neobar...some of those bigger kids can also get their hands out of a wrap and grab on with two hands! We are gong to be trialing a few other ones I think. I love them on the little ones....saves their skin on their face and makes moving that tube so much better!

We still do use tape on the really small micronates...we have two right now that are in the 425gm range (severe IUGR 26 weekers) and the bar just wasn't working.

[walkingrock, ADN]

Agree with the above 2 posters.

[littleneoRN]

We use tape or tube holders from Smith Medical. What I don't like about the ones from Smith is that there is a second piece you click in at the base to secure the tube, and sometimes it's hard to twist it the right way while also holding your tube secure. Also, they don't stick very well. I'm old-fashioned, but I love tape. It's secure, and you can size it perfectly to your patient. Unless you're repositioning your tube, which is when it doesn't come in very handy. Generally, you don't have to adjust the position very often, but it happens sometimes. I don't love the amount of play on the Neobars...we don't sedate very heavily, so this can cause problems.

[Bortaz, MSN, RN]

I am not a big fan of the amount of movement on neobars. And I find that a lot of people just don't understand the proper placement of the bar...over top lip? Middle of the mouth? There is just no consistency, and I hate walking up and finding that we're digging out a new cleft palate with the darn ett.

One super tiny babes, we also just use tape.

[nicurn5]

My current unit uses tape but I don't like the tape they use it is very easily torn when wet with secretions. I prefer to use the Neobar and tape it in place (and yes it still moves around but not nearly as much as the tape we use to secure out ETT's).

[SteveNNP, MSN, NP]

My old unit used the Portex X-shaped ETT holders, and I like those a lot better than the neobars. Neobars tend to get gross, and never quite look like your tube is being held securely.