Tubed medical devices and children

On this page

• Types of medical devices with tubing
• Risk of medical devices with tubing
• Managing the risk
• Reporting a serious adverse event

Medical tubing is used extensively to deliver therapy (nutrition, oxygen or medical substances) to children both in the hospital and at home.

Types of medical devices with tubing

Enteral feeding devices

Enteral feeding devices (known as an enteral feeding delivery set) deliver nutrition to patients who are unable to eat or swallow.

The set of tubing can be attached to a pump to give the young patient either milk/formula or nutritional formula. Tubing is inserted through the nose or mouth and passes directly to the stomach.

This device can also be used without a pump, as formula is given with a gravity bag and clamp.

Nasal cannulas and oxygenation devices

Nasal cannulas tubing devices have 2 prongs that sit in the nostrils. The prongs bring oxygen (high or low flow) into the nostrils.

This type of device is used to treat a wide range of conditions, such as:

• COVID-19
• pneumonia
• sleep apnea
• heart failure
• collapsed lung
• respiratory failure
• chronic obstructive pulmonary disease (COPD)

It’s also used to help those who have difficulty breathing.

Intravenous (IV) delivery devices

IV tubing allows access to peripheral veins to deliver continuous or intermittent fluids or medication. This type of device is used in a wide variety of cases, such as to administer:

• antibiotics
• antifungals
• chemotherapy
• blood products
• pain relief drugs
• rehydration fluids

Risk of medical devices with tubing

Tubing from medical devices can accidentally wrap around a child and may cause entanglement, strangulation or death.

Health Canada has reviewed the potential risks posed by these types of devices. We looked at information from the Canadian incident reporting database, the U.S. incident reporting database and peer-reviewed literature.

As of September 1, 2022, no deaths due to this risk have been reported in Canada. However, 2 toddler deaths have been reported in the U.S. and near misses have been reported in Canada.

Managing the risk

While there have been few serious adverse events in Canada, the severity of this risk and the consequence to families and children is severe and life-altering.

To ensure young patients in Canada are as safe as possible, particularly in the home-care environment, Health Canada recommends the following.

Home caregivers

• Remove device tubing that is not being used from areas where a child may become entangled.
• Coil or secure excess tubing.
• Discuss this risk with your child’s health care provider, including:
  • best practices to minimize the risk of entanglement
  • other devices, such as tapes or housings, that are recommended to secure tubing and minimize the risk of entanglement
  • what to do if the child becomes entangled in tubing or is unable to self-rescue
  • other questions or concerns about the risk of entanglement with the tubed medical devices you use

Health care providers

• Work with your health care institution or consult your professional association on risk management options.
• Ensure standard risk management procedures are in place.
• Inform caregivers who may be providing care in a homecare environment of these risk management options.

Reporting a serious adverse event

It’s important to monitor any issues with using tubed medical devices so you can take action before an adverse event happens.

• Talk to your health care provider about what to do if there’s a problem with using the device.
• Contact the manufacturer if there’s a technical problem with the device.
  • They must provide manuals and training on how to use the device.
  • They must tell you what to do if you have a side effect or if the device fails.

Health Canada encourages you to report adverse events:

• Consumer Medical Device Report Form

Report a medical device problem:

• Consumer
• Hospital
• Health care provider