AMT Bridle™ System Frequently Asked Questions

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 stay. 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 a 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.

Is there an increased risk of infection or sinusitis with the AMT Bridle System?

To date, over 60,000 AMT Bridles have been placed in over 75 institutions and there has been no documented increase incident of sinusitis associated with the use of the AMT Bridle. See Clinical Studies on Bridling.

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, over 60,000 AMT Bridles have been placed in over 75 institutions.

What happens if the patient pulls on the AMT Bridle device?

If a patient pulls on the tube secured with the Bridle, they will create pressure on the the vomer bone at the back of 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, over 60,000 AMT Bridles have been placed in over 75 institutions.

How long can the Bridle stay in?

The Bridle can be left in place for the entire duration of the feeding tube's useful life.

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 60,000 AMT Bridles have been placed in over 75 institutions. For the user, you have the assurance that you are working with a clinically proven, FDA approved product, not something that has been pieced together.
Patient Comfort – With the magnetic retrieval system, there is no need to gag the patient by reaching into their mouth as is required in the homemade technique.
Time Savings – The AMT Bridle can be placed in under a minute. Published reports on unplanned tube removal suggest an incidence of 40%. In the event of unintentional dislodgement or migration, the Bridle will save hours in reinsertion time.
Optimal Materials – In a clinical study NOT sponsored by AMT, Seder and Janczyk (Nutr. Clin. Pract., Dec 2008) observed that 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 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. The rare-earth magnets used in the Bridle are sensitive to high temperatures. Steam or heat sterilization will de-magnetize them.

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 too small to cause any permanent disturbance to pacemakers.

What goes into the cost of a Bridle?

FDA Requirements – Patient safety is a top priority for AMT and for the FDA. If one of the Bridle magnets were to come loose and be ingested by the patient, they must not cause any harm to the patient. The magnets are gold plated because gold does not tarnish and does not react with the body. For these reasons, gold is used for jewelry and Bridle magnets.
Powerful Magnets – To ensure a strong connection between the insertion probe and the retriever probe each time the Bridle is used, expensive rare-earth magnets are required. These are up to 100 times more powerful than a refrigerator magnet. To meet the small size requirements, stock magnets must be ground down to the desired diameter with a diamond wheel.
Hand Made – The Bridle is hand assembled in the USA. Although visually simple, each Bridle consists of several small components which are hand assembled and secured together. The correct polarity (North – South orientation) of each magnet must exist and all components must be securely fastened.
Unique Materials – The Bridle insertion probe (white) is a specialty elastomer and is a proprietary material developed by AMT. This material allows a strong connection between the magnet, tubing, and cotton umbilical tape. It is very flexible and glides easily across the mucosal lining of the nose to ensure reliable, smooth passage of the Bridle each time. The retrieval probe (blue) is a special flexible composite material which allows it to comfortably pass through the nose yet give the clinician the ability to manipulate the tip for magnet contact.
Commitment to Education – AMT hosts educational in-services to train nurses and physicians on proper use of the Bridle, often for multiple shifts and recurrent training for new staff. AMT maintains an interactive website with educational content available 24/7 and has produced numerous training materials and videos.