A nasal bridle is removed by cutting one side of the umbilical tape and gently pulling the tape and feeding tube out through the nose. The process takes only a few moments, but it should be performed by a trained medical provider. If you or a family member has a bridled feeding tube, understanding how the device works and what removal looks like can help you feel prepared when the time comes.
How a Nasal Bridle Works
A standard nasogastric (NG) tube is held in place with adhesive tape on the skin, which can peel off easily, especially in patients who are restless or confused. A nasal bridle adds a more secure anchor. During placement, a clinician threads a thin catheter into one nostril and a magnetic probe into the other. The two magnets connect behind the nasal septum (the thin wall of bone and cartilage between your nostrils), pulling a loop of cloth umbilical tape around the back of that bone. The ends of the tape exit both nostrils and are clipped to the feeding tube on the outside.
The result is a small loop of soft tape sitting behind the septum, physically tethering the feeding tube so it can’t be accidentally pulled out. The clip that connects the tape to the tube locks with a snap closure and is only meant to be reopened by someone trained in the system.
Who Should Perform the Removal
Only a trained medical provider should remove a nasal bridle. This isn’t a device you should attempt to take out at home unless specifically instructed in an emergency, and even then, hospital guidelines from Children’s Wisconsin and similar institutions direct patients and families to go to the emergency department for removal or replacement. The tape sits around a delicate bone inside the nose, and improper removal could cause bleeding or injury to the nasal septum.
Step-by-Step Removal Process
Removal is straightforward once you know the anatomy involved. The process differs slightly depending on whether the feeding tube is coming out along with the bridle, or whether only the bridle is being removed while a new tube is placed.
Removing Both the Bridle and Feeding Tube
The clinician cuts one side of the umbilical tape between the nose and the external clip. This breaks the loop that was holding everything in place behind the septum. Then they gently pull both the bridle tape and the feeding tube out through the nose together, with the clip still attached to the tube. The whole assembly comes out as one piece.
The tube should never be yanked or forced. NG tubes can occasionally become kinked or knotted, and steady, gentle traction is important. If there’s unexpected resistance, the provider will stop and assess before continuing.
Removing Only the Bridle
Sometimes the bridle needs to come off while the feeding tube stays in place, for instance when switching securement methods. In this case, the clinician cuts one strand of the bridle tubing, opens the clip to detach it from the feeding tube, and then gently pulls the freed tape out through the nose. The feeding tube remains in position and is re-secured with tape or a new bridle.
What It Feels Like
Most patients tolerate bridle removal well. Research reviewing the patient experience found that people who were alert enough to report their comfort level generally did not complain of increased discomfort from the bridle itself, and removal is quicker and simpler than insertion. You may feel a brief tugging or tickling sensation as the tape slides out from behind the septum, and some mild irritation in the nostrils afterward. Significant pain is uncommon.
Proper positioning of the tube and bridle before removal helps reduce the chance of skin irritation. Clinicians typically ensure there’s no tension on the tape or tube before cutting, so the tape slides freely rather than dragging against irritated tissue.
Possible Complications
The most common issue during removal is minor nosebleeding (epistaxis), which can happen when the tape passes over the nasal lining. This is usually brief and resolves on its own. More serious complications like erosion of the nasal septum are rare and are more associated with prolonged use of the bridle rather than the removal itself. If the tape has been in place for a long time, the tissue around it may be more sensitive, which is another reason gentle technique matters.
Retained fragments of tape are a potential concern if the tape is cut in the wrong spot or pulled carelessly, which is part of why trained providers handle this step.
Care After Removal
After the bridle and feeding tube come out, oral hygiene is an important next step. NG tubes can cause dryness and irritation in the mouth and throat, and cleaning up after removal helps prevent sores and infection. A provider may also check the skin around the nostrils for any breakdown from the clip or tape, especially if the bridle was in place for several days or weeks.
The nostrils themselves may feel slightly raw or dry. Gentle cleaning and keeping the area moisturized can help the tissue recover. Any persistent bleeding, increased pain, or signs of infection like redness or swelling around the nose should be reported to your care team promptly.