I know I have heard, but unfortunately cannot locate any written material, that the use of kerlix to wrap around a PICC/midline catheter causes increased pressure on the underlying veins where the edges overlap and this is unacceptable practice. 

Anyone know where I can find this in print? 

Peggy

When our daughter was

When our daughter was battling Neuroblastoma, she was 9 months old when the PICC was placed. She was to sensitive to tape to secure the Lumen and cap, as are most kids and adults, especially over a period of time. We were also worried she would rip it out because she was very active and wanted to play. Way to much stress. She also wanted to chew on the cap. Teething.  When our daughter had the Central line put in we encountered the same problem. Nurses really had no solution other than tape or gause for either the PICC or Central Line.  Neither worked effecently. So my wife went home and sketched out and sewed a solution. The nurses and surgical and PICC teams were so impressed they kept calling us for to see if we had some for other patients. (Central line caps in diapers is a common problem)

You can see the solutions on Innovation Blog that Childrens Hospital Boston wrote on our family and how we Innovated out of necessity

vectorblog.org/2012/09/patients-can-innovate-too-putting-a-wrap-on-picc-lines/

 

 

 


Mike

CareAline™ Products are unique, one-of-a-kind Line Management systems/garments for PICC, Central Lines, PEG Tubes, G-GJ Tubes and various

I believe it would be a

I believe it would be a theory or anecdotal. However we don't always have to have a study done to fix obvious potential problems. We had to fight and fight to get the staff to stop using Coban. I think our team knows how to appy it correctly, however, what about the next guy and the guy after that? It is sad that we have to make policy to the lowest common denominator. But that is the reality. It is very likely that it won't get taken off for assessment or will be put back on too tight.

We now use a tubular stockinette. I think it is a product for casts (?) or some type of ortho product (?). It is the weight of a thin sock and can be cut to fit. It works for peds to large adult....but not super-sized arms. It is flesh colored and outpatients really love it. We order it in 25yd boxes.

I should add that we do not tape around and around it. It is more like a t-shirt sleeve that can be easily lifted for assessment and manipulations. It is more to deter patients that pick at the dressing or tubes. Or to just cover it up for modesty (outpatients). We still use a statlock, tegaderm, and biopatch dressing.

Martha

LOOSELY bound with Kerlix. 

LOOSELY bound with Kerlix.  This is an excellent, low tech, method of deterring the patient from premature self-removal of their line.    For the facilities that use this method I recommend removing the Kerlix each shift for insertion site and limb assessment.  As far as I know there is no written research or documentation available.   Lynda

I have never seen this

I have never seen this written anywhere specific for this brand of roller bandage for PICCs. Many years ago we routinely used Kling or Kerlix to wrap arms with PICCs. This was long before engineered stabilization devices. Kling and Kerlix are not stretchy and probably will not cause the pressure you are asking about. Other elastic bandages could easily put this pressure on the site though. Roller bandages are never recommended for a peripheral IV site because it can easily obscure the site so tht early signs of a complications could go undetected for a long time. I have also seen this happen with a PICC in a neonate - when a nurse finally removed all of the bandages and stockinette protecting the PICC, they found an arm with severely compromised circulation. The PICC had been placed in an artery and this baby lost the arm. So many reasons not to use any bandage that prevents the nurse from easily viewing the site. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861