Securing OGTs

[millyk30]

I need some suggestions on how to secure OG tubes with babies on NCPAP. My unit is currently using NG strips, but they are constantly getting wet from the CPAP and oral secretions and causing the tubes to become too shallow or come out. Does anyone do something differently? Anyone secure them somehow to the CPAP hat? Thanks.

[Mags4711, RN]

It is a challenge, isn't it?

I secure OG's one of two ways, my preferred method is to cut a long thin strip of tape (maybe 1/8 inch by 2 inches or so) and wrap it around the OG once so that it has tails hanging off (kind of like you do when you place an NG). Whichever side of the mouth I place the OG in, I bring the OG across the chin and tape it with tegaderm/opsite or another long strip of tape. My other method is to tape the OG in across the upper lip like a moustache. When I place an OG, I usually add a centimeter or two to allow for looping in the mouth.

[elizabells, BSN, RN]

Heee, THIS one I can definitely answer - NGs and OGs seem to be the task I do most often, other than ostomy care. We take a patch of duoderm and place it on the chin, drop the tube, and then secure it with a larger patch of tegaderm. So it goes straight down to the tip of the chin. We change all OG/NG tubes q24, unless there's an MD order otherwise (like if it was difficult to place and someone other than just us had to do it). Sometimes replogles have to be done by surgery and have to be placed just so - like on some of the NEC babies.

[NicuNightRN]

For OGT's, I place a patch of tegaderm on the chin then use on top of it to secure the tube - cut almost in half lengthwise so there is a tiny bit left holding the two halves together. The bottom half I put on the tegaderm, and the top half I wrap around the tube.

For NGT's, I use put a piece of tegaderm on the cheek, as close to the nose as I can get it.

[prmenrs, RN]

I say, staple 'em in!

(jk)

[BittyBabyGrower, MSN, RN]

Naw...super glue :roll We do the duoderm and tape method on the chin...but when they slobber, it is all over and we end up doing them a lot.

[SteveNNP, MSN, NP]

We use cath-lock's when they are in stock ( tiny bowtie shaped duoderm with a velcro closure on top. We peel and stick to the chin and secure the tube with the velcro. Otherwise for NG's or when we're out of cathlocks, I'll use 1/2" pink tape, cut a slit halfway down, chevron the 2 strips around the tube and slap another short strip across the whole thing to hold it in place. These last quite a while, but the baby usually manages to hook his thumb under the tube and pop it out anyway. It's kind of funny seeing 14cm of og tube flapping in the wind, with 30cc of formula in your freshly changed bed.

[Gompers, BSN, RN]

We always tape our OG tubes with a moustache-style tape. We use either duoderm on the checks and 1/2 inch white fabric tape for the moustache, or we'll just use pink Hytape. By doing the moustache right under the nose and over the sides of the cheeks, we avoid a lot of the saliva that drools down the babies' chins. We try to change to NG as soon as possible, though, because they are much more secure for our babies. If a baby is PO feeding at all, we'll do an NG. Usually their nares are big enough for a 5fr NG PLUS a cannula or Vapotherm (well, Fisher Paykal at the moment, but same difference). We used to use the long-prong CPAP and then we'd always do OG tubes, but again, moustache tape. Now that we don't use any actual CPAP anymore, NGs are much more common for us.

[Tomskatt]

I like the sound of that stapleing method, but until that gets approval we go with plain old tegaderm on the cheek and tube....

[danissa, LPN, LVN]

Heee, THIS one I can definitely answer - NGs and OGs seem to be the task I do most often, other than ostomy care. We take a patch of duoderm and place it on the chin, drop the tube, and then secure it with a larger patch of tegaderm. So it goes straight down to the tip of the chin. We change all OG/NG tubes q24, unless there's an MD order otherwise (like if it was difficult to place and someone other than just us had to do it). Sometimes replogles have to be done by surgery and have to be placed just so - like on some of the NEC babies.

Hi there, so do you change tubes every 24hrs? we do it weekly unless they have been pulled out by the babes or are precarious in position.

[LilPeanut, MSN, RN, NP]

We do tegaderm on the cheek, and sometimes the mustache method :)

[elizabells, BSN, RN]

Hi there, so do you change tubes every 24hrs? we do it weekly unless they have been pulled out by the babes or are precarious in position.

we change about q24 unless, as above, there's a compelling reason not to. We feed q3, usually, so what I try to do is pull it soon after the feeding is done to give the skin a chance to rest, and then drop the new one for the next feeding. I haven't had any really unstable kiddos, though, so it might be different for them.