Patient information: information was not provided by reporter.Date of event: the customer did not have specific dates of events.The events reportedly occurred in april and may.Lot #, expiration date, manufacture date: lot number was not provided by the reporter.Without a lot number, it is not possible to determine the manufacturer date or expiration date.The respiratory therapist from this facility reported he felt the cause of extubations was multifaceted.The unit was using a new taping technique, using a new tape, had a rare influx of "micropremies" and had new staff.In addition, he suggested the infant's oral secretions, isolettes with high humidity and slight flexibility/movement in the tape may all be factors.The rt reported there was no formal 3m training prior to starting use of the tape.The rt used training videos for instruction.The 3m technical specialist followed up with the rt and discussed product application.The 3m account representative and 3m clinical specialist plan to schedule and provide product training for the respiratory therapists and nurses.To maximize adhesion of multipore (tm) dry surgical tape for tubing securement, the following application techniques are recommended: apply 3m¿ cavilon¿ no sting barrier film to protect at-risk skin.Allow to dry completely before applying tape.(with following disclaimer) *3m¿ cavilon¿ no sting barrier film may be applied to adults, children and infants over 1 month of age.Cavilon no sting barrier film is not recommended for infants under 1 month of age.Apply tape to clean, dry skin and devices.Apply tape with some tension to reduce gaps and looseness, but do not overstretch the tape to devices and skin.After application use firm pressure to maximize adhesion to tube and/or skin.If possible, spiral the tape around the tubing to maximize surface area of adhesive to tubing.Monitor tape adhesion periodically.It is recommended tape be replaced if it becomes overly saturated, loose or soiled.Access the following link for additional training videos:go.3m.Com/ctsapplications please work with your local sales representative for additional training as needed.Unplanned extubations (ues) are adverse events occurring in mechanically ventilated patients.Premature dislodgement of the endotracheal tube (ett) by the patient or staff is a more common event among pediatric and neonatal populations.The occurrence rates in the literature for critically-ill pediatric patients are not as consistent, however risk factors are nearly identical.Agitation and restlessness due to the minimal use of sedatives or muscle relaxants, ett fixation challenges, use of cuff-less etts, environmental conditions like high humidity, copious secretions, the potentially longer duration of intubation than in adults, and physical manipulation of the patient from repositioning, kangaroo care, general nursing care, and during procedures all contribute to an increased potential for unplanned extubation in the nicu and picu (pediatric intensive care unit) populations.
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