Saturday, October 29, 2016

IV Taping - Sticky to Sticky

Recently a bright, young whippersnappern skillfully started an IV in my old, wrinkled up hand  during a hospital procedure. An impressive array of task specific material was used to secure the IV. The first order of business for this bright young nurse was to slap a piece of tape across the hub of the catheter and then plaster apply a transparent covering and then finally cover the whole business  with a fancy flat donut shaped gizmo.   This might work for an old geezer like myself that is just going to lie in bed, fat, dumb, and happy, but there is a much more secure method for more active patients like that epileptic seizing or the poor sole detoxing.

 This taping trick was demonstrated to me when I was a much younger fool by an old wise nurse that was very experienced with wild and wooly patients. It is one of the more useful procedures I utilized and a lot more fun than administering  Kayexelate enemas or attempting to force a Gelfoam slurry down an NG tube during a bad GI bleed.

Archimedes said give me a lever and a place to stand and I will move the world. Here is another very powerful force; adhesive dressing tape when stuck  together sticky side to sticky side forms a formidable bond. Any object (IV catheter, NG tube, Foley or whatever) that is between the two sticky surfaces is going to stay there. Please pardon my foolish illustration, but my lack of writing skills probably could not describe the taping procedure. This is really an effective way to tack down an IV catheter so please bear with me.

A. Tear two 1/2 inch strips of tape about 5 inches long from a standard 1 inch roll of tape. I am impressed with the vast array of tapes available today; dermaclear, micro pore, mega pore, or whatever. The only tape I had available was that J+J dressing tape that took the strength of a gorilla to tear apart. Some nurses used scissors to cut it, but I just loved the sound of that tape ripping and patients were impressed that I could tear it with my bare hands.

B. The illustration shows the 2 strips of tape and I have colored one black to indicate which is the sticky side. Take the sticky side up tape strip and center it under the hub of the catheter so there is about 2 inches or a little more on each side. Fold these two pieces of tape down at a right angle to the catheter leaving a margin of sticky side up tape about 1/4 inch on each side of the catheter. If the patient is really rambunctious or you are working with a larger lumen tube like a Foley, make the sticky zone bigger. This sticky on sticky zone is where the rubber meets the road. It doesn't really require very large area when properly aligned.

C. Now we are about to unleash the incredible strength of sticky on sticky by placing the second strip of tape directly over the hub of the catheter engaging the sticky side up portion of the first piece of tape. If done correctly, the sticky on sticky parts of the tape are fully engaged around the catheter firmly anchoring it in place. If you want to avoid problems at tubing change times, keep the IV tubing free of the sticky on sticky zone. Now you can apply your transparent occlusive dressing and the insertion site is readily available for inspection for problems.

The nurse that started my IV did not loop the tubing because it was a short term procedure and I was not very boisterous (an understatement if I've ever heard one.)  If you combine the sticky on sticky catheter securing method with a sticky on sticky secured looped tubing you have a formidably tacked down IV that should pass the "jerk" test which was named after me the originator of the test (Oldfoolrn.) Go ahead and give that IV tubing a hearty yank. It's not going anywhere.


7 comments:

  1. Thank you! I miss this mentoring.

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  2. That is how I was taught to tape an IV securely, too!
    Young W.Snappers looked at me like I was crazy, until I showed them the 'jerk' test!!
    Are you sure we're not related?!?!

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  3. Bobbie, I think all older nurses share a bond forged in the hospital cauldron of unpleasant odors, overbearing supervisors, adversity, and hollering doctors. I think we always tried to put the patient's needs above anything else. When young whippersnapperns have so many alternatives to bedside nursing, it warms my heart to see so many bright youngsters toiling with direct patient care. They are a special breed.

    One caveat - That "jerk" test does not work well with Foley catheters.

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  4. You can always tell when the IV team at my hospital puts in the IV, they use sticky to sticky!

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  5. IV teams were in their infancy when I was working, Liz. Someone emailed me a question about using sticky to sticky with winged IV catheters. I remember Vasculon IV catheters that had wings and we just extended the sticky zone a couple of millimeters past the distal end of the wing. It really prevented those wings from taking flight...OOPS, I can't avoid that maturity onset foolishness.

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  6. LOL ~ no, I NEVER did the jerk test on a Foley!!!

    I love seeing BY's at the bedside...

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  7. My OB experience was limited to 12 weeks in nursing school, but I vividly remember old time obstetricians (male of course) suggesting that labor could be hastened by "cervical ripening." This was done by applying traction (a nice way of saying pulling)on an indwelling Foley catheter. YEOW... and if labor is not painful enough.

    I wonder how the good OB men would feel about a prostate ripening procedure that involved pulling on a Foley. What's good for the goose is good for the gander!

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