A few months after my son’s Eosinophilic Esophagitis diagnosis, and after attempts to identify and eliminate specific food allergens from his diet didn’t help, my son was taken off all of food. He was put on Neocate, a brand of elemental formula which provides 100% of his nutrition. Like many kids with EE, this eventually also required a feeding tube since he would not take enough by mouth to sustain him. He got a nasogastric (NG) tube, which is a feeding tube that goes through the nose.
While the nurses in the hospital trained us on many aspects on how to deal with an NG tube, there was one thing that we had to figure out through trial and error: how to tape the thing! According to our doctor’s advice we were to change the tube every month (not a pleasant experience, but I won’t go into that now), but the tape on his face does not last that long before pealing off or collecting a lot of dirt, so we usually need to change it on a weekly basis. In fact, in the beginning the the tape would hardly last a day–because apparently the nurses didn’t know how to do it right. I have nothing against them. They helped us in a lot of ways. But it took a while to find one who taught us the taping technique that actually worked. Before this, we tried the minimalist approach, where you just try to put a few small pieces of tape in key locations to keep the tube positioned. This didn’t work, of course, as those small pieces quickly come loose. Then we tried the overkill approach, where we basically covered the entire side of his face in tape. Not only did it make him look bad, it also bothered him quite a bit, and still didn’t work very well. After a few unrelated visits to the doctor, we finally met a nurse who knew how to do it right. And I’m passing it on to you. I don’t expect this information to be useful to just anyone who randomly passes by this blog. But perhaps it will be useful to someone in the future in our situation.
Supplies
You will need two types of medical tape: Duoderm and Tagaderm, both of which are tape specially made for use on bare skin. You will want the “extra thin” Duoderm, which is more flexible. The one time we accidentally ordered the regular variety did not go as well. Where can you find them? We get the Tagaderm from Walgreens and the Duoderm from eBay (otherwise known as our “secondary medical insurance”), or you can get it from medical facilities.
Preparation
Cut a strip of Duoderm about 1 inch by 3 inches. Cut a similar strip of the Tagaderm about the same size (perhaps a little larger). If you get the Tagaderm that’s in 4”x4” sheets, you can just cut a sheet in half. After you take the backing off of the Tagaderm, you have to be careful when handling it since it’s a little like plastic wrap–it can shrivel up. You’ll want to cut it while the backing is still on, and then remove the backing just before you apply the tape.
Make sure the side of the face that you will be applying the tape is clean and dry.
Application
Place the strip of Duoderm horizontally on the cheek. You want it to be close enough to the nose so that there is not a lot of room between the nose and the tape for small fingers to get it and pull out the tube, but not so close as to interfere with the movement of the mouth. This is something you’ll get the hang of with practice.
Hold the feeding tube on top of the Duoderm tape. It is not sticky on the top. Then apply the strip of Tagaderm on top, creating a sandwich with the tube in the middle of the Duoderm and Tagaderm strips.
Why it Works
It makes sense when you think about it. If you’ve tried other techniques, you might have noticed that the tape gets pulled away from the face too easily. It’s very hard to keep it adhered. This method works because you first apply the Duoderm flush with the face, so it sticks very well. Then, by applying the Tagaderm on top with the tube in the middle, the Tagaderm sticks very well to the Duoderm–much better than it sticks to bare skin.
Also, since the Duoderm is flesh colored (as long as you are caucasian), and the Tagaderm is clear, it is about as discrete as you can get.
An added benefit is that you can sometimes just change the top layer of tape and leave the Duoderm in place.
If this was helpful to you, please comment. It takes some practice, but you can do it. Hang in there.
If my instructions weren’t clear enough, here’s the finished result:
Actually stumbled across this by accident, but needed info for other bandage areas for my sick mother…may have eventually tried it (i have the materials), but thanks..this is a great idea! I’ll definately try this out for keeping flat, and (less than adhesive, seems a normal problem) bandages on and maybe now theyl actually be waterproof like they claim..
Thanks for taking the time to inform others
Wonderful tutorial on taping the tube!! We figured this out by now, but this is very well written.
So much of this EE and tube stuff is trial and error. Thanks for taking the time to put this out here!
Thanks for sharing. We are doing it the same way!
thanks! our baby has a new ng tube and after just changing the dressing twice i am in a fit of tears. i will try this,at least it shouldn’t rip a layer of skin off.
I’m a physician (20 years ) and this is about the best NG securing technique I have seen. Great resource.
This is exactly how we have been doing it. One thing I am not able to do, though, is change the tape (Tegaderm) without changing the tube. And it gets pretty gross sometimes. How do you do this?
I am so grateful to have come across this. My husband and I just brought home our 6-week-old on an ng tube, and have been experimenting with the tape in frustration since she’s been here. I am going to try this as soon as I get my hands on some duoderm. Again, thank you. If this works, it will be such a burden off my heart right now.