Applied Medical Technology 4-4210 - AMT Bridle Pro Nasal Tube Retaining System - 10F Bridle Pro (Teal), 5/BX

Applied Medical Technology 4-4210 - AMT Bridle Pro Nasal Tube Retaining System - 10F Bridle Pro (Teal), 5/BX

AMT Bridle Pro System

The Bridle Pro system consists of a retrieval probe, a flexible monofilament bridle catheter (bridle tubing) which houses a removable stylet guide, a pre-attached clip, a clip opening device, and a packet of water-soluble lubricant.

The AMT Bridle Family of Nasal Tube Retaining Systems, are specifically designed for both pediatrics and adults. Routine bridling has become the standard of care for many ICUs due to improved nutritional outcomes and cost management. Individually packed spare Bridle Pro and AMT Bridle clips can be ordered in a box of 5 each based on your facility needs.

What is a Nasal Bridle?

What is it?: A nasal bridle is a securement method used to discourage patients, young or old, from pulling on their nasoenteric feeding tube. Reports show that 40 percent of nasogastric feeding tubes are dislodged, which may lead to the unnecessary surgical placement of a feeding device or conversion to parenteral nutrition support.* A nasal bridle is an effective and safe way to secure a patients nasal tube, retaining the nutrition flow to the patient. What does it look like?: The nasal bridle system has several distinct pieces; a blue retrieval probe, a catheter with removable safety stylet and blue bridle tubing, a pre-attached clip, a removal tool and a lubricant packet. Most of these components serve to thread the bridle into place within the nasopharynx. Once properly inserted, only the soft bridle tubing and device clip remain. The other pieces are discarded. The blue retrieval probe and catheter have strong rare earth magnets at their tips. The retrieval probe is inserted into the nostril without a nasal tube. The catheter with safety stylet and bridle tubing is inserted into the opposite nostril. Both the probe and stylet are advanced towards the back of the nasal septum where the two magnets will connect around the vomer bone inside the nasal cavity. The magnets allow the two pieces to unite creating the bridle loop with bridle tubing. Once the bridle loop has been established, slide the pre-attached clip up the bridle tubing to approximately 1cm or alternatively one finger width from the nostril, and just above the lip. Then place the nasal tube into the clips defined nasal tube region. From here, take the loose strands of bridle tubing and place them within the clip, and close the clip. Once the clip is closed, tie the two strands of bridle catheter together into a simple knot below the clip, and cut the excess 1cm below the knot, securing the nasal tube.

Improving nutritional outcomes while reducing nasal tube pullout costs!

The AMT Bridle Family has been shown to:

• Dramatically reduces pullout by 72%
• Reduce costs of extended length of stay due to sub-optimal nutrition
• Reduce costs of clinicians time to replace nasal tube(s)
• Reduce costs of new nasal tube, formula, and supplies
• Reduce unreimbursed expenses under managed care
• Reduce costs of secondary x-ray or fluoroscopy
• Reduce costs of hospital-acquired conditions from nasal tube migration

How Does a Nasal Bridle Work?

Once the bridle tubing is passed through both nostrils and around the vomer bone, it uses the structure of the nasal cavity, specifically the vomer bone, to hold the feeding tube in place. If patients pull on the tube, they will feel a little pressure on the bone, making the bridle uncomfortable for a moment, but not painful. This deters them from continuing to pull on the tube. The goal is to secure the nasal tube in place without causing any damage.

The AMT Bridle Family may reduce the risk of complications from using a feeding tube without damaging the nose or causing pain to the patient. It deters pulling and also helps to prevent accidental dislodgement of the feeding tube, giving the patient more freedom to move normally.

With a device like the AMT Bridle or Bridle Pro, there is no reason to tape or suture the feeding tube into place. This cost-effective AMT Bridle Family is barely visible and takes only about a minute to properly place. Through better tube securement the patient will experience enhanced nutrition and fewer complications like aspiration or sinusitis. Use of the AMT Bridle Family can dramatically reduce the occurrence of accidental tube dislodgement, avoid skin breakdown and lead to cost savings. It is a superior solution to prevent nasal tube dislodgement.

The Importance of the AMT Bridle Family

Consistent nutrition support plays an important role in the management of nutritional deficiencies and is part of the standard of care for critically ill patients. The AMT Bridle system dramatically reduces feeding tube pullouts, resulting in an improved caloric intake. It is critical to maintain nasal tube securement in the neonatal and pediatric populations to ensure essential nutrition delivery to their growing bodies and avoid unnecessary nasal tube replacements. Conventional methods of tube securement using tape often lead to premature pullouts, dislodgement, and skin breakdown. For pediatric patients, AMT recommends placing the Bridle device prior to any nasal tubes.

Risks of Securement with the Alternative Method: Marginal adhesive effectiveness Skin breakdown Dislodgement of nasal tube Allergic reaction due to adhesive Nasal septal damage Inadequately secured nasal tubes expose patients to risks including: Aspiration Pneumothorax Radiographic exposure Early and unnecessary transition to PEG/TPN Sinusitis Pressure necrosis Interruptions to nutritional support More frequent replacement procedure

Benefits of the Bridle Family Securement Method: FDA Cleared for pediatric use FDA Cleared for use with ANY brand of nasal tube Available in sizes to secure nasal tubes as small as 5F MR safe after proper placement No patient sedation required The Bridle Family of Devices is a Safety Device: Specifically designed by a physician Manufactured by AMT, the inventors of the AMT Bridle technology AMT has over 15 years of bridling product experience Device secures around the strong vomer bone Device strength and retention designed for patient safety All device components will release or break well below the amount of force needed to cause injury.

Bridle Pro Innovations

Pro Range Clip:

The Pro Range Clips flexible overmolded inner section allows it to encompass multiple sizes into a single clip. Pro Range Clips 5F-6F and 8F-10F are smaller for pediatric patient use.

• Can accommodate more than one French size of nasal tubes
• Available in 5-6F, 8-10F, 12-14F, and 16-18F
• Rigid inner portion of the clip is strong, secure, and easy to close
• Soft over-molded portion increases patient comfort, especially in pediatric patients
• Clip comes pre-attached

Pro Clips:

• A wide variety of French size specific clips, ranging from 8F to 18F
• Can accommodate the large Salem Sump tubes
• Clip comes pre-attached

Blue Bridle Tubing:

• Softer, smoother, and more comfortable for the patient during and after placement
• Lubricant is no longer necessary, but lubricant or water may be used if desired
• Approximately 60% decrease in surface area when compared to umbilical tape
• Tubing is easy to clean
• Monofilament tubing

New Standard of Care

Routine bridling has become the standard of care for many ICUs, due in part to improved nutritional outcomes and cost management. Rather than restrict bridling to patients with a history of tube pullouts, the cost savings have compelled universal use on all nasal tubes in many key healthcare facilities around the world.

Only the AMT Bridle family is available in the widest range of sizes (5-18F) and cleared for use with all nasal feeding tube brands.

Quick Reference Guide for the AMT Bridle Pro System

The AMT Bridle Pro is easily placed using magnets to draw bridle tubing through the nasopharynx; in one nare, around the vomer bone, and out the other nare, then securing it to the nasal tube with a French Size specific clip. AMT has provided this information as an educational resource. Do not attempt to use the AMT Bridle Pro without also reviewing the products complete Directions for Use (DFU).

Frequently Asked Questions

Questions: What are the main difference between the AMT Bridle and the Bridle Pro?

AMT Bridle

• White umbilical tape
• Lubricant is needed for placement and is included in the product packaging
• Bridle Clips French size specific clips come pre-attached to the white umbilical tape

Bridle Pro

• Blue monofilament bridle tubing
• No lubricant is needed, however, it is included in the product packaging
• Bridle Pro Range Clips - Accommodate a range of French sizes and come pre-attached to the blue bridle tubing
• Bridle Pro Clips - French size specific clips come pre-attached to the blue bridle tubing

Questions: Is there an increased risk of infection or sinusitis with the AMT Bridle family of devices?

To date, hundreds of thousands of AMT Bridles have been placed in over hundreds of institutions and there has been no documented increase of incidents of sinusitis associated with the use of the AMT Bridle Family of Devices. Specifically, the Bridle Pro has the new bridle tubing which is a monofilament. This bridle tubing offers approximately 60% less surface area than umbilical tape bridles and is easy to clean.

Questions: What happens if the patient pulls on the bridle devices?

If a patient pulls on the tube secured with the AMT Bridle or Bridle Pro, they will create pressure on the vomer bone at the back of the nasal septum/vomer bone, which will cause discomfort. This negative reinforcement will deter most patients from pulling further on their tube. Despite this, some patients will continue to pull. The increased force on the tube will cause the outside diameter of the feeding tube to narrow and slip through the clip before damage occurs to the vomer bone at the back of the nasal septum.