Procedure/Treatment/Home Care Si usted desea esta información en español, por favor pídasela a su enfermero o doctor. #1665 Name of Child: Date: What it is: Nasal Bridle (Nasal Feeding Tube Retaining Device) The nasal bridle (sometimes called a nasal feeding tube retaining device) helps to keep the feeding tube in place. It has a clip attached to a string that is threaded through your child s nose. The nasal bridle should not harm your child s nose when it is in place. If your child s feeding tube is pulled on, it may feel uncomfortable. If the feeding tube is pulled on with great force, then the nasal bridle clip will pop open but it will not cause injury to your child. Your child s nasal bridle is the same size as your child s feeding tube. It needs to be changed every 4-6 weeks at the same time as your child s feeding tube. You will need to schedule an appointment with your child s doctor every month to change the nasal bridle and feeding tube. The nasal bridle helps keep a feeding tube in place. If your child is in the emergency room or hospital, the nasal bridle may be changed earlier than a month. Then you can wait another month for your child s doctor to change the feeding tube and nasal bridle. For instructions on how to care for your child s feeding tube safely, ask your child s nurse or doctor for the handout: How to Feed Your Child Through a Nasogastric (NG) Tube #62 1 of 7
How to care for the nasal bridle: Clean your child s nasal bridle clip and nose as needed with warm water. Check the nasal bridle for signs of damage every day. Make sure that it is holding the feeding tube in place. One week before your child is scheduled to have the nasal bridle removed or replaced, add a drop of saline into each side of the nose each day. This can help make it easier to remove the nasal bridle. Ask your child s nurse or doctor if you need help with this. Important: Look at the nasal bridle, feeding tube, and your child s nose for any changes. Make sure that the feeding tube and nasal bridle have not moved. If they have moved, do not feed your child until you are sure the feeding tube is in the right place. Ask your child s nurse or doctor where you can get saline. What to do if the feeding tube has moved: Call your child s doctor right away or take your child to the emergency room if: You have not been taught how to open the nasal bridle clip Your child has a nasoduodenal (ND) tube Your child has a nasojejunal (NJ) tube If your child has an nasogastric (NG) tube and you have been taught how to open the nasal bridle clip: 1. Wash your hands for 15-30 seconds. Dry your hands with a clean towel or paper towel. If your hands are not visibly dirty, you can use alcohol based hand rub to clean them using the following steps: Put enough alcohol based hand rub to fill the palm of your hand. Spread the hand rub over all parts of your hands. Rub hands together until dry. 2. Have your child sit in a comfortable position. Tell your child to sit very still. If needed, have someone help you keep your child still. 3. Use the clip-opening tool to open the nasal bridle clip as you were taught. 4. Hold onto the clip, NG feeding tube, and string so the string does not slide back into the nose. 2 of 7
5. If the NG feeding tube has moved cm or less, push the same tube back into the right position. 6. If the tube has moved more than cm, remove the NG feeding tube and replace it. 7. Check to make sure the NG feeding tube is in the right place. Do not feed your child through the feeding tube if you are not sure it is in the right place. 8. Close the nasal bridle clip to hold the NG feeding tube in place. What to do if the nasal bridle clip is broken or is not holding the feeding tube tightly: Call your child s doctor right away or take your child to the emergency room. If you have been taught how to open the nasal bridle clip, follow these steps to remove your child s nasal bridle: 1. Wash your hands for 15-30 seconds. Dry your hands with a clean towel or paper towel. If your hands are not visibly dirty, you can use alcohol based hand rub to clean them using the following steps: Put enough alcohol based hand rub to fill the palm of your hand. Spread the hand rub over all parts of your hands. Rub hands together until dry. 2. Have your child sit in a comfortable position. Tell your child to sit very still. If needed, have someone help you keep your child still. 3. To remove the NG feeding tube and nasal bridle: Cut only one strand of the string above the clip. Gently pull the NG feeding tube and nasal bridle out of your child s nose. 4. To remove only the nasal bridle: Hold onto the string to prevent your child from accidentally swallowing the string. It can easily slide back into the nose if you do not hold the string when you cut it. Cut only one strand of the string above the clip. Use the clip-opening tool to open the clip. Remove the NG feeding tube from nasal bridle. 3 of 7
Add a drop of saline into each side of the nose. Gently pull the nasal bridle from the nose. Tape your child s NG feeding tube to the cheek to keep it in place. Check to make sure the feeding tube is in the right place. Do not feed your child through the feeding tube if you are not sure it is in the right place. Call your child s doctor right away if your child has any of the following: bloody nose sores in or around the nose increased amount of mucous headache or pain in the nose that does not go away after taking medicine a temperature above 101.5º F orally (by mouth). Now that you have read this: r Tell your doctor or nurse what a nasal bridle is, and how you will care for it (Check when done.) r Tell your doctor or nurse when you would call your child s doctor or when you will bring your child to the emergency room. (Check when done.) If you have any questions or concerns, call your child s doctor or r call 4 of 7
If you want to know more about child health and illness, visit our library at The Emily Center at Phoenix Children s Hospital 1919 East Thomas Road Phoenix, AZ 85016 602-933-1400 866-933-6459 www.phoenixchildrens.org www.theemilycenter.org Facebook: facebook.com/theemilycenter Twitter: @emilycenter Pinterest: pinterest.com/emilycenter Disclaimer The information provided at this site is intended to be general information, and is provided for educational purposes only. It is not intended to take the place of examination, treatment, or consultation with a physician. Phoenix Children s Hospital urges you to contact your physician with any questions you may have about a medical condition. May 10, 2016 DRAFT to family review #1665 Written by Nicki Mitchell, MSN, RN, CPN Illustrated by Irene Takamizu and Christine Remmel 5 of 7
Nasal Bridle (Nasal Feeding Tube Retaining Device) Name of Health Care Provider: Date returned: r db Family Review of Handout Si usted desea esta información en español, por favor pídasela a su enfermero o doctor. #1665 Health care providers: Please teach families with this handout. Families: Please let us know what you think of this handout. Would you say this handout is hard to read? r Yes r No easy to read? r Yes r No Please circle the parts of the handout that were hard to understand. Would you say this handout is interesting to read? r Yes r No Why or why not? Would you do anything differently after reading this handout? r Yes r No If yes, what? After reading this handout, do you have any questions about the subject? r Yes r No If yes, what? 6 of 7
Is there anything you don t like about the drawings? r Yes r No If yes, what? What changes would you make in this handout to make it better or easier to understand? Please return your review of this handout to your nurse or doctor or send it to the address below. The Emily Center 602-933-1395 Health Education Specialist Phoenix Children s Hospital 1919 East Thomas Road Phoenix, AZ 85016-7710 Thank you for helping us! 7 of 7