The AMT Bridle™
Nasal Tube Retaining System
The AMT Bridle™ Family of Nasal Tube Retaining Systems.
The Comfortable Alternative for Nasal Tube Securement
The AMT Micro Bridle™
Designed specifically for pediatric comfort
Compared to the AMT Standard Bridle™:
Strength and retention force were specifically designed to avoid injury in delicate pediatric tissue and bone, even in the event of pulling. Every component of the AMT Micro Bridle™ will release or break well below the amount of force needed to injure a pediatric vomer bone.
AMT is the original Bridle manufacturer with a history of improvements and innovations. The only clinically documented nasal tube retaining system on the market; the AMT Bridle may be imitated, but never duplicated.
Eliminate Pullouts & Reduce Costs
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.
Inadequately secured nasal tubes expose patients to risks including:
- Radiographic exposure
- Early and unnecessary transition to PEG/TPN
- Skin breakdown from adhesive
- Pressure necrosis
- Interruptions to nutritional support
- More frequent replacement procedure
The AMT Bridle™ Nasal Tube Retaining System has been shown to:
- Reduce cost of extended hospital stay due to sub-optimal nutrition
- Reduce cost of clinicians’ time spent replacing nasal tubes
- Reduce cost of new nasal tube, formula, and supplies
- Reduce cost of secondary x-ray or fluoroscopy
- Reduce unreimbursed expenses under managed care
What is a Nasal Bridle and What Does the AMT Bridle™ Look Like?
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, leading 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 patient’s nasal tube, retaining the nutrition flow to the patient.
What does it look like?:The nasal bridle system has distinct pieces; a blue retrieval probe, a white catheter with removable safety stylet and attached umbilical tape, a French size specific 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 umbilical tape and French size specific clip remain. The other pieces are discarded.
The blue retrieval probe and white catheter have strong earth magnets at the end. The retrieval probe goes into the nostril free of the nasal tube and the catheter with safety stylet and attached umbilical tape goes into the other. 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 umbilical tape.
Once the bridle loop has been established, the nasal tube is placed into the groove of the clip, approximately 1cm below the nostril and just above the lip. The clip is pre-attached to the umbilical tape for ease of placement and secures the feeding tube in place.
How Does a Nasal Bridle Work?
With the umbilical tape threaded 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.
Using an AMT Bridle 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.
Maintaining the tube with the bridle in place is easy, as well. There is no reason to tape or suture the feeding tube into place. This cost-effective AMT Bridle is barely visible and takes only about a minute to install.
Better tube securement means enhanced nutrition and fewer complications like aspiration or sinusitis. Use of the AMT Bridle 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.
How to Place the AMT Bridle™ System
The AMT Bridle is easily placed using magnets to draw umbilical tape through the nasopharynx; in one nare, around the vomber bone and out the other nare, then securing it to the nasal tube with a French Size specific clip.
Frequently Asked Questions
AMT has provided this information as an educational resource tool. This is not intended as a substitute for professional medical care. Your FIRST source of information should be your healthcare provider.
HOW DOES THE AMT BRIDLE SYSTEM SAVE MONEY FOR THE PATIENT AND HOSPITAL?
OPTIMAL NUTRITION – OPTIMAL RECOVERY – It is generally believed that early aggressive enteral feeding facilitates faster patient healing with a resultant decrease in ICU and hospital stays. Use of the AMT Bridle™ minimizes interruption of tube feedings, thereby enhancing patient nutrition. Although difficult to measure, this factor may translate into the greatest cost-saving and health benefit of all Bridle features.
SAVINGS ON TUBES, X-RAYS, AND NURSING TIME – Use of the AMT Bridle System results in significant cost-savings, especially when every tube is Bridled. A study conducted at the University of Pittsburgh Medical Center estimated that using the Bridle for all their tubes (1440 per year) would result in 275 fewer tubes, 330 fewer X-Rays, and 45 fewer nurse-days (Gunn, et. al., JPEN Vol 33, Feb 2009).
SAVINGS ON ENTERAL NUTRITION FORMULA – If a tube is pulled out, replacement can take several hours which can result in the need to discard expensive enteral nutrition formula. Use of the Bridle dramatically reduces pull-outs, so waste is also minimized.
SAVINGS ON STAFF TIME AND LAUNDRY COST – If a tube is pulled completely out, the formula is pumped onto the patient’s bed. The result is a messy cleanup which wastes staff time and adds to laundry costs. Bridling prevents most pull outs so these expenses are avoided.
APPROXIMATE COST ANALYSIS: COST OF REPLACING 1 FEEDING TUBE*
- Cost of Feeding Tube: $26.00
- Cost of X-Ray: $340.00
- Cost of Radiologist Read: $35.00
- Cost of Nursing Time: $28.00
- Approximate Total Cost: $429.00
- Approximate cost to replace 2 feeding tubes: $858.00
- Approximate cost to replace 3 feeding tubes: $1,287.00
*Information taken from multiple sources
IS THERE AN INCREASED RISK OF INFECTION OR SINUSITIS WITH THE AMT BRIDLE SYSTEM?
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.
WILL THE AMT BRIDLE™ DEVICE DAMAGE THE NASAL SEPTUM?
All tubes passing through the nasal cavity can irritate the nasal mucosa as can the Bridle umbilical tape. The Bridle tape should be lubricated before placement. The Bridle tape should rest without tension in the nose when properly applied. Any minor irritation of the nasal mucosa will heal rapidly when the Bridle and tube(s) are removed.
To date, hundreds of thousands of AMT Bridles have been placed in over hundreds of institutions.
WHAT HAPPENS IF THE PATIENT PULLS ON THE AMT BRIDLE™ DEVICE?
If a patient pulls on the tube secured with the AMT Bridle™, 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 clamp before damage to the vomer bone at the back of the nasal septum occurs.
To date, hundreds of thousands of AMT Bridles have been placed in over hundreds of institutions.
HOW LONG CAN THE BRIDLE STAY IN?
The Bridle is only cleared for up to 30 days of continuous use.
WHY SHOULDN'T I USE A ``HOMEMADE`` BRIDLE?
SAFETY – The AMT Bridle™ clip is designed to allow some slipping should a patient pull so hard that they might hurt themselves. To date, over hundreds of thousands of AMT Bridles have been placed in hundreds of institutions.
PATIENT COMFORT – The magnetic retrieval system allows for a gag-free interface with the patient since you are not reaching into their mouth, as is required in the homemade technique.
TIME SAVINGS – The AMT Bridle™ can be placed in under a minute. Published studies on unplanned tube removal suggest an incidence of 40%. In the event of unintentional dislodgement or migration, the Bridle can save hours in reinsertion time.*
OPTIMAL MATERIALS – A clinical study, not supported by AMT, was performed by Seder and Janczyk (Nutr. Clin. Pract., Dec 2008) that determined the use of red rubber catheters in homemade bridles resulted in 4 cases of nasal ulceration per 800 tube feeding days. However, they observed no ulceration with umbilical tape. The rate of tube pull out was also decreased with the umbilical tape. All materials used in the AMT Bridle™ have been specifically chosen to optimize performance and safety.
WHAT IS THE SAFETY RECORD OF THE AMT BRIDLE™ SYSTEM?
Bridle techniques have been used for more than 20 years. The AMT Bridle™ system, in use for over ten years, builds on the safety record of the “homemade” version by making the loop around the vomer bone easy to create.
WHY CAN'T THE AMT BRIDLE™ SYSTEM BE RE-USED?
The AMT Bridle™ is designed to be a single-use disposable product.
WILL THE AMT BRIDLE™ SYSTEM MAGNETS DISTURB A PACEMAKER?
The AMT Bridle™ magnets are used only to create the loop around the vomer and do not stay in place; additionally, they are very small but to date there have been no incidences to pacemakers. Consult your physician.