I/V catheter bandages

Re: I/V catheter bandages

Juliet Drummond DAVN (med) RVN D32/33 — Tue, 28 Dec 2010 22:00:28 GMT

in my experience everyone has their prefered method.

i leave feet out, i find that the most common cause of foot swelling is tape that is too tight. i use micropore under the catheter and wrapped around to make a wee house for the hub, pinch it down onto the hub. if patient likely to move around alot, i use sticky elastoplast (over the micropore) to form the loop, otherwise i just use micropore.

i feel strongly that the dressing should be suffiecient to support the vein,the catheter and provide patient comfort, i also think the dressing needs to be removed and the site assessed at least once each day. i hate to see a wee bit vetrap that barely covers the catheter.

i like to use a cut swab under the hub of the catheter.

as for the kink resistors, i have used these in the past, i found them fiddely and can dig into the skin if not padded properly.

personally i have not found a better giving set than infusion concepts moduflo supreme range. these have disconnection point near the patient, for walks etc, and the end part is completely kink resistant, without being to bulky, it is also a long set with a section of pump compatable tubing.

to be honest though for me its all about aseptic placement , and patient comfort.

good discussion topic.

Re: I/V catheter bandages

dinny_06 — Tue, 28 Dec 2010 14:53:39 GMT

KirstyJane, very good topic to start :)

I will just give you a run down of how i tape in my i.v catheters.

Using elastoplast cut into four strips.

- Using 1 tape under the wings of the catheter

- 2nd strip tape over the wings of the catheter ensuring that it is not tapped too tightly.

-Place giving set onto catheter and use the 3rd strip further down the limb to secure the g.s. By applying the 3rd strip it prevents the g.s and catheter from being pulled out as easily. However do not loop the g.s. as the other poster said it is more likely to cause kinks.

I then apply a small amount of softband and then vetwrap around the catheter and g.s but i do not include the toes. I myself feel that little is better as the patient is less likely to interfere with the catheter.

Re: I/V catheter bandages

Leigh Hinsley RVN NCert(BDev) MBVNA — Mon, 27 Dec 2010 21:15:36 GMT

[quote user="Sal (the 1st) Holesworth VN CMH Chyp (M)PNLP"]

thank you so much for your input on this Leigh - and I really mean that

[quote user="Leigh Fisher"]

I qualified last year and was taught at college the correct way was to enclose the foot in the bandage

[/quote]

you have just illustrated something perfectly that I have been trying to get across for ages. Just who is it who decides exactly what is the correct way to do things and also makes the decisions that other people are wrong?

[quote user="Leigh Fisher"]

I do agree with the many other points made - an enclosed foot routinely gets soiled one way or the other so usually requires daily redressing meaning stress for the animals, its difficult to monitor the catheter and line closely and when you've got a big dog bandaging the entirely leg which must be uncomfortable/irritating for the dog.

[/quote]

thank you for being able to see something from another perspective rather than sticking rigidly to the 'rules' whatever they may be these days

[quote user="Leigh Fisher"]

as I said, I often see swollen feet on animals whose foot is not enclosed - but when that's the only pro from many cons, perhaps just close monitoring and non-enclosed foot would suffice? [/quote]

at last a commonsense approach - wouldnt life be so much easier if a few more people could accept that their way isnt the only way

And no I am not being patronising at all

[/quote]

You're very welcome!

And P.S. - Merry Christmas and Happy New Year to everyone! x

Re: I/V catheter bandages

Sal the 1st — Mon, 27 Dec 2010 16:09:33 GMT

thank you so much for your input on this Leigh - and I really mean that

[quote user="Leigh Fisher"]

I qualified last year and was taught at college the correct way was to enclose the foot in the bandage

[/quote]

[quote user="Leigh Fisher"]

[/quote]

thank you for being able to see something from another perspective rather than sticking rigidly to the 'rules' whatever they may be these days

[quote user="Leigh Fisher"]

as I said, I often see swollen feet on animals whose foot is not enclosed - but when that's the only pro from many cons, perhaps just close monitoring and non-enclosed foot would suffice? [/quote]

at last a commonsense approach - wouldnt life be so much easier if a few more people could accept that their way isnt the only way

And no I am not being patronising at all

Re: I/V catheter bandages

Leigh Hinsley RVN NCert(BDev) MBVNA — Mon, 27 Dec 2010 12:38:52 GMT

I qualified last year and was taught at college the correct way was to enclose the foot in the bandage - and when I do I always find it stops the foot swelling. However I do agree with the many other points made - an enclosed foot routinely gets soiled one way or the other so usually requires daily redressing meaning stress for the animals, its difficult to monitor the catheter and line closely and when you've got a big dog bandaging the entirely leg which must be uncomfortable/irritating for the dog. But as I said, I often see swollen feet on animals whose foot is not enclosed - but when that's the only pro from many cons, perhaps just close monitoring and non-enclosed foot would suffice?

Re: I/V catheter bandages

Sal the 1st — Mon, 27 Dec 2010 10:30:50 GMT

Millpledge do them - if I could get onto their online catalogue I would post the link - but I cant so I wont. Would just add dont use them with the soft wall i/v sets because if you have an animal that moves around a lot and pulls against the drip line you stand a really good chance of collapsing the line. In saying that I havnt had the need for them that often you can get a similar effect at no cost using the middle of a vetwrap roll.

Re: I/V catheter bandages

Maisy — Mon, 27 Dec 2010 10:08:06 GMT

[quote user="Phrin SVN"]

T connectors are v good! Have used them and have them in current practice, but the little plastic things that stop looped back IV's kinking are the best for kitties & small dogs! Anyone know where to get them from and how much?

[/quote]

Kink resistors! Definitely better for looping, esp depending on what type of giving set used as some of the more rigid lines kink easier when looping back.

You can buy them in singles from wholesalers and most suppliers, don't think they're any more than a £ each.

Re: I/V catheter bandages

Phrin Vernon RVN — Sun, 26 Dec 2010 23:46:17 GMT

[quote user="Nick BATFINK Shackleton Dip AVN(surg)VN"]

[quote user="Phrin SVN"]

I used to work at a place that had these funky little plastic things - think half circle shape that fits around a giving set 'loop' - meaning they can't kink!

They were fab as they meant that you had the benefits of a looped back giving set without the giving set kinking.

We don't have them at my current practice, so I am less likely to loop back the giving set.

[/quote]

T-connectors are even better! Port right by the catheter for IV drugs/flushing and allows for easy disconnection for walkies!

[/quote]

Re: I/V catheter bandages

Nick Shackleton — Sun, 26 Dec 2010 23:08:04 GMT

[quote user="Phrin SVN"]

I used to work at a place that had these funky little plastic things - think half circle shape that fits around a giving set 'loop' - meaning they can't kink!

They were fab as they meant that you had the benefits of a looped back giving set without the giving set kinking.

We don't have them at my current practice, so I am less likely to loop back the giving set.

[/quote]

T-connectors are even better! Port right by the catheter for IV drugs/flushing and allows for easy disconnection for walkies!

Re: I/V catheter bandages

Phrin Vernon RVN — Sun, 26 Dec 2010 21:45:23 GMT

I used to work at a place that had these funky little plastic things - think half circle shape that fits around a giving set 'loop' - meaning they can't kink!

They were fab as they meant that you had the benefits of a looped back giving set without the giving set kinking.

We don't have them at my current practice, so I am less likely to loop back the giving set.

Re: I/V catheter bandages

Vicky RVN — Sun, 26 Dec 2010 17:50:04 GMT

With putting a loop in...i do for all dogs, find they stay in better as they don't stand on it with their other foot and pull it so easily. With cats....sometimes i loop, sometimes i don't, depending on how it goes if that makes sense!

We colour code vetwrap....anything red has a catheter, all other colours don't.

Re: I/V catheter bandages

Mrs Dot Dot — Thu, 23 Dec 2010 23:06:08 GMT

Really like the idea of colour coding but we also use alot of the no-chew bandage.... luminous green and supposedely bitter tasting!

Re: I/V catheter bandages

Phrin Vernon RVN — Thu, 23 Dec 2010 22:08:59 GMT

good thread! we don't so much colour code, but have paw patterned bandage that is only to be used on pressure dressings post catheter removal - same idea really - do not send home anything unless it has either no dressing, or a paw patterned dressing

Re: I/V catheter bandages

Steph Worsley — Thu, 23 Dec 2010 21:59:50 GMT

we never bandage the foot in unless paw getting swollen and only then once the tape has been checked, prob about 1% of our cases have a foot bandaged in for all the above reasons

We also colour code our vet wrap so much so that we have nothing but red and blue in stock!

Re: I/V catheter bandages

Nick Shackleton — Thu, 23 Dec 2010 21:53:13 GMT

[quote user="Phrin SVN"]

So lint free swabs are the way to go

[/quote]

Yes I was trying to say avoid soffban or other such materials

Re: I/V catheter bandages

Phrin Vernon RVN — Thu, 23 Dec 2010 21:50:24 GMT

So lint free swabs are the way to go

Re: I/V catheter bandages

Nick Shackleton — Thu, 23 Dec 2010 21:49:11 GMT

Sorry phrin re-typed my post!

Re: I/V catheter bandages

Phrin Vernon RVN — Thu, 23 Dec 2010 21:48:09 GMT

[quote user="Nick BATFINK Shackleton Dip AVN(surg)VN"]

[quote user="Phrin SVN"]

Just to add another discussion - I try and place a piece of swab or soffban under the actual hub of the catheter and the catheter/giving set attachment when placing IV's, as I reckon that they must dig in to the patients skin - especially in long term IVFT

Does anyone else do this? Ideas on how to do it best? I find that a teeny tiny bit of padding works best otherwise I get all tangled up whilst trying to tape in!

[/quote]

If anything stay clear of soffban or anything else with lint/fibres ie swabs.

have used soffban and colour coded co-flex (red: iv in blue: iv out) or k-band.

[/quote]

why?

Is there a cheapish alternative?

Re: I/V catheter bandages

KirstyJaneRVN — Thu, 23 Dec 2010 21:47:21 GMT

Thanks for your replies guys, I've never had a problem with swollen feet that I know of but hey ho! Nick love the idea of colour coding the vetwrap for catheters in / out.

Re: I/V catheter bandages

Nick Shackleton — Thu, 23 Dec 2010 21:29:38 GMT

[quote user="Phrin SVN"]

Does anyone else do this? Ideas on how to do it best? I find that a teeny tiny bit of padding works best otherwise I get all tangled up whilst trying to tape in!

[/quote]

If anything stay clear of soffban or anything else with lint/fibres and stick with lint free materials ie swabs.

have used soffban and colour coded co-flex (red: iv in blue: iv out) or k-band.

Re: I/V catheter bandages

Phrin Vernon RVN — Thu, 23 Dec 2010 21:02:29 GMT

Does anyone else do this? Ideas on how to do it best? I find that a teeny tiny bit of padding works best otherwise I get all tangled up whilst trying to tape in!

Re: I/V catheter bandages

Louise B — Thu, 23 Dec 2010 20:55:43 GMT

Hiya, this is a really good topic/question.

Bandaging a whole dog's foot in is one of my absolute pet hates in practice. I hate to see it done as I think it just masks bad bandaging technique (i.e. too tight) in most cases. It really annoys me - especially because:

a) People rarely cover the dressing when they take the patient outside so they often end up soiled/wet

b) People put off walking a patient on i/v fluids when it is wet or snowy or muddy outside because it is more time consuming if they bother to cover the foot before taking the patient outside

Either way I think the patient suffers.

But I have worked with nurses who hold equally strong views in the other direction too.

Re: I/V catheter bandages

Phrin Vernon RVN — Thu, 23 Dec 2010 20:42:16 GMT

For some reason I thought your initial post was about cat IV's only!

I very rarely include a dogs foot in an IV bandage unless they are teeny tiny, then I try and leave the toes out as for cats.

Most dogs appear to tolerate a light dressing just around the IV site well. When I do these dressings I make sure the vetwrap or equivalent is not too tight by placing a couple of fingers under each turn of the bandage before letting the tension go - if you know what I mean? Seems to work well - haven't had a pooch with a swollen foot in the last year or more that I can remember.... (Sue may come on now and tell me that all my Friday IV placements result in Saturday fat feet lol!)

Re: I/V catheter bandages

KirstyJaneRVN — Thu, 23 Dec 2010 20:25:12 GMT

Thanks yeah that's exactly what I thought, whatever works for you..

Would never be disrespectful enough to completely re-bandage an animals leg "because in my opinion my way's the correct way".

Shame some people are tho

Re: I/V catheter bandages

Phrin Vernon RVN — Thu, 23 Dec 2010 19:39:43 GMT

Hiya

I have seen and done it both ways, and I can see the merit in both - enclosing the foot in a bandage can help to prevent the foot swelling in my experience.

However I now prefer to leave the toes out like you would with a RJ, as the cats seem much more comfortable with it that way, and they don't soil the dressing with urine when using the litter tray.

I must admit that in my earlier nursing days this would result in swollen toes, but now that my bandaging skills have improved this happens only very very rarely, and is spotted quickly when it does occur.

All the SVN's, RVN's and vets at our practice have their own take on how to bandage a cat IV line in, all (mine included) with their pro's and con's. For example I dislike taping the giving set back up to the leg in a loop, as I feel it encourages kinking..... but by not taping it back up I also find that occasionally my dressings are 'shaken' off by the cat - whereas those that are looped back are much more likely to stay put.

Swings and roundabouts - I don't think there is a single correct way to do it