Securing enteral tubes in paediatric facial burns; overcoming the challenge

Ms Linda Quinn1, Dr Lachlan  Farmer1, Dr Edward Gibson1, Dr Amy Jeeves1, Dr Rebecca Cooksey1, Mr Darren Molony1, Dr Michelle Lodge1, Mr Bernard Carney1

1Women’s And Children’s Hospital, North Adelaide , Australia

Abstract:
Securing enteral tubes in paediatric facial burns; overcoming the challenge.

Introduction

Enteral feeds are important in paediatric burns patients with an injury >15% total body surface area (TBSA) to ensure their increased metabolic demand for protein and calories is met. Securing nasogastric tubes (NGT) or trans-pyloric tubes (TPT) in this cohort is especially difficult when the face is also involved and frequent dislodgement is common. This can lead to prolonged healing time and aspiration as well as the need for frequent replacement of the NGT or TPT.

Discussion

The Home Enteral Nutrition Service (HENS) at the Women’s and Children’s Hospital has introduced the AMT BridleTM , nasal tube retaining system for a range of patients to prevent accidental or intentional tube removal. One of the indications is for difficulty in attaching the tube to the face e.g. burns or excoriation. The Burns Service were experiencing difficulties with securing both NG and TPT to a 90% TBSA burn patient and it was suggested that a bridle may assist.

This presentation will discuss this method of securing enteral feeding tubes, our experience with using it in two major burn patients and our plans for its future use.

Biography:
Linda has worked at the Women’s and Children’s Hospital for the majority of her 30 year nursing career post registration. She has extensive paediatric surgical experience and has specialised in paediatric burns nursing since 2006. She has post graduate qualifications in both paediatric and burns nursing.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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