BRIDLE - Frequently Asked Questions
Is the
AMT
Bridle™ economical for routine use?
The
AMT
Bridle™ dramatically reduces the incidence of inadvertent nasal tube removal.
Therefore, the
AMT
Bridle™ saves on the need of replacement tubes, physician and nurse time to insert tubes, x-rays to confirm tube placement, fluoroscopy to re-insert tubes, and endoscopy to re-insert tubes.
Most importantly, the
AMT
Bridle™ maximizes the amount of time the patient receives nutrition, which can lead to a more rapid recovery.
What types of patients benefit from use of the
AMT
Bridle™ ?
The
AMT
Bridle™ is useful in all patients where inadvertent removal of the tube is likely, and a patent airway is available on both sides of the nasal septum.
The
AMT
Bridle™ is especially useful in circumstances where tube removal could lead to adverse events such as tubes placed through a fresh surgical anastamosis.
How long can the
AMT
Bridle™ stay in?
The
AMT
Bridle™ can be left in place for the entire duration of the feeding tube’s useful life.
What is the safety record of the
AMT
Bridle™ ?
Bridle techniques have been used for more that 20 years.
The
AMT
Bridle™ system builds on the safety record of the “homemade” version by making the loop around the septum easy to create.
The only complications observed with “homemade” umbilical tape bridles were the occasional defeat of the system by a determined patient.
The clinical trial of the
AMT
Bridle™ system conducted at the Cleveland Clinic disclosed no complications.
Is there an increased risk of infection or sinusitis with the
AMT
Bridle™ ?
The risk of sinusitis is increased with any tube or instrument passing through the nasal cavity.
Clinical trial data using the
AMT
Bridle™ and
“homemade” umbilical tape bridle systems has not identified an increased risk of infection beyond that associated with a single tube passing through the nose.
Will the
AMT
Bridle™ damage the nasal septum?
All tubes passing through the nasal cavity can irritate the nasal mucosa as can the
AMT
Bridle™ umbilical tape.
The
AMT
Bridle™ tape should rest without tension in the nose when properly applied.
Any minor irritation of the nasal mucosa will heal rapidly when the
AMT
Bridle™ and tube(s) are removed.
Will the
AMT
Bridle™ cause nasal bleeding?
Nasal bleeding can be caused by placement of any nasal tube including the
AMT
Bridle™.
Like all tubes, the
AMT
Bridle™ should not be forcefully inserted into the nose. Once the
AMT
Bridle™ is in place, an increased incidence of bleeding has not been observed.
What happens if the patient pulls on the
AMT
Bridle™ ?
If a patient pulls on the tube secured with the
AMT
Bridle™, they will create pressure on the back side of the nasal septum, 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 usually will cause the outside diameter of the feeding tube to narrow and slip through the clamp before damage to the bone at the back of the nasal septum occurs.
However, if a clinician believes a patient may pull on the
AMT
Bridle™ to such degree as to cause serious injury, then the
AMT
Bridle™ should not be used, and the clinician should employ another means to secure the feeding tube.
Will the
AMT
Bridle™ magnets disturb a pacemaker?
The
AMT
Bridle™ magnets are too weak to cause any permanent disturbance to pacemakers.
For added safety, it is recommended to keep the
AMT
Bridle™ magnets in the head and neck area only in patients who have pacemakers.
What are the contraindications to
AMT
Bridle™
use?
The
AMT
Bridle™ is contraindicated in patients with nasal, facial, or skull fractures, and those with mechanical obstructions to the nasal airway.
The
AMT
Bridle™ should be used with caution in patients who have nasal septal perforations due to drug abuse.
For those patients, a thorough nasal exam is recommended before
AMT
Bridle™ placement in the patients to ensure that adequate bone remains in the posterior septum to support the
AMT
Bridle™ system.
A nasal exam should also be conducted after
AMT
Bridle™ placement to ensure that the umbilical tape loop has passed behind the nasal septum rather than through a septal perforation.
Although the
AMT
Bridle™ is not contraindicated in patients with a severely deviated nasal septum, placement of the
AMT
Bridle™ may be difficult or impossible.
A patent airway is necessary on both sides of the nasal septum to allow
AMT
Bridle™ insertion.