How to Place the AMT Bridle™ Device
A thorough nasal exam is recommended before AMT Bridle placement in 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. NOTE: System is supplied non-sterile, for single use only.
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AMT Bridle™ Device — Directions for Use
NOTE: The preferred position is to place the patient supine. The AMT Bridle™ may be placed before or after the nasal tube.Important: Lubricate the probe, catheter and umbilical tape. Insert the blue probe into nostril opposite the nasal tube until the first rib is at the bottom of nostril. Make adjustment for smaller patients.
Insert the white Bridle catheter into the opposite nostril to approximate the magnets. Pull back on the orange stylet about 1cm (1/2”) until the magnets connect. The “click” of the magnets may be heard or felt. Equal lengths of both probes (minus the orange stylet) should be exposed.
If necessary, gently twist the probes from side to side and/or up and down to encourage contact between the magnets. If no contact has occurred, then advance both the white catheter and the blue probe. Important: Once contact has occurred, remove the orange stylet completely from the white catheter and dispose.
Slowly withdraw the blue probe and allow the white catheter to advance through the nose. Continue until only the cloth umbilical tape is in the nose. This creates a loop or “bridle” around the vomer bone. If catheter and umbilical tape do not advance out of the opposite nostril, remove catheter, replace the stylet and start over at Step 1.
Cut the catheter portion from the umbilical tape. Dispose of white catheter and blue probe. If the nasal tube has not been placed, insert now.
Important: Use caution when handling the AMT Bridle clip near patient's mouth; consider covering patient's mouth. Clip should be located close to nostril, approximately 1cm (1/2”) or one “finger width” from nostril. NOTE: The clip should not touch the nostril. For clip sizes 5-12F: Place the nasal tube into the clip's channel or groove. For clip sizes 14-18F see the last slide.
Ensure nasal tube fits securely in channel. Keeping them flat, place both strands of umbilical tape near the hinge of the clip.
Close the clip by folding over the plastic edge and firmly snapping it shut. NOTE: The clip is difficult to re-open, so ensure proper position of the nasal tube, umbilical tape and clip prior to closure. ALSO NOTE: Some nasal tubes are more rigid than others and may require a higher force to close clip. WARNING: Do not use any foreign object to open or close clip as this may damage the clip, making it less secure and/or ineffective. If damaged, use a new clip.
After the clip has been fully closed, tie the two umbilical tape ends together (excluding the tube) creating a simple knot. Repeat 2-3 times.
The AMT Bridle™ may remain in place for the entire time the feeding tube is in place. Note the placement of the AMT Bridle in the patient's chart. WARNINGS: Throughout the useful life of the AMT Bridle, the clip must be visually inspected for signs of damage or loose attachment to the nasal tube. Monitor the clip and nasal tube position regularly for feeding tube migration.
As an option, a single strand of umbilical tape may be placed in the clip and tied off.
To remove the AMT Bridle™ and tube: Cut only ONE strand of the umbilical tape. Gently pull both the Bridle and nasal tube out of the nose. To remove only AMT Bridle: Cut both ends of umbilical tape and remove (clip remains in place). CAUTION: Great care must be taken to prevent accidental swallowing as the tape can easily slide back into the nose.
Step 6: Clip Sizes 14-18F ONLY!
Ensure nasal tube fits securely in channel. Keeping them flat, place both strands of umbilical tape between the soft inner portion of the clip and the outer, more rigid plastic section.