Canberra Hospital and Health Services Clinical



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Emergency Removal of ET Tube


  1. Carefully cut thin portion of the neobar at the junction of the bar and the flaps

  2. Remove the ET tube attached to stabilising platform.


Alert

Discontinue Neobar immediately if skin irritation occurs.
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Section 4 - Nasal Endotracheal Tube Strapping/Restrapping




Purpose


The purpose of Section 4 is to describe the procedure for the securing of a Nasal Endotracheal Tube (ETT) to prevent movement, possible trauma and extubation.
Restrapping should occur if the tube is mobile or has moved +/- 0.5cms from the correct position as nominated on x-ray.


Equipment


  • Skin protection barrier wipes

  • (2) 2.5cm wide Leucoplast strip cut to approximately 5cm long

  • (3) Narrow pieces of leucoplast - 4cm long

  • (1) trouser leg shaped length

  • (2) lengths cotton tape 1x20cms and 1x10cms

  • Measuring tape

  • Alcohol based hand rub


Procedure


  1. Monitor the baby throughout the procedure

  2. Ensure there is a medical officer in the unit at all times throughout the procedure

  3. If the baby should extubate during the procedure start resuscitation measures as per SOP neonatal resuscitation

  4. Apply skin protection wipes To nose & Across forehead where it is to be strapped






  1. Place a large piece of thick leucoplast across forehead, see illustration, ensure tape is above eyebrows



  1. Fix trouser leg tape into position

  2. Ensure each leg is strapped securely and firmly against the nostril around the ETT to stabilise - avoid pressure

  3. Wind tape around tube

  4. X-Ray to ensure correct position. X

  5. X-ray not required for restrap only




  1. Take the narrow/short length of cotton tape (green), fold in half length wise

  2. Using short piece of narrow leucoplast, secure lower half of cotton tape to tube next to base of trouser leg




  1. Take second wider/long length of cotton tape (white)


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