Taping sites

We need info on how you learned to tape your sites and pull your needles unassisted. There was a thread on this in the past , but can not seem to find it. Would appreciate it if someone could find the prior thread or any new responses on how you do this.

There really wasn’t much to learn. The needles usually stay where they are once in the hole until you pull them out (both pre and post treatment), and so it gives you time to work with your free hand while you tape or untape. To pull the needles out after treatment, I attach a scissor clamp at the end of each needle tube, so I can pull the needle out with the hand on my fistula arm, while I hold a gauze ready with the other hand. It’s not hard to do.
Pierre

Thanks Pierre, how about taping the needles down- is there a way to prepare the tapes and gauze so you can reach them easily and get them on without them sticking to your fingers?

What extra things do you have to do to secure the needles and lines for nocturnal txs?

When pulling the needles out with the line in your hand does the needle ever feel a little stuck from dried blood… do you just give it a little more force to get it out?

To tape down, I normally use one 10 x 12 Tegaderm cut in half, with one half for each needle. So, I prepare that ahead of time when I do my needle tray. When I do short daily sometimes, I just use ordinary paper tape just as they do at the dialysis centre, so I prepare those ahead of time too. I prepare my 4 gauzes by taking them out of the package and laying them on my needle tray as well. So everything is ready ahead of time. I do this while my machine is running through its alarm test. I also prepare ahead of time one length of plastic tape for the leak detector, and two lengths of paper tape for taping my sites after.

When doing daily nocturnal or short daily, my centre wants us to secure the bloodline/needleline connections by wrapping a short lenght of plastic tape around them. We call this a “bridge”, and the purpose of this is to prevent the connector from gradually unscrewing itself. It’s not as important for short daily, but we do it anyway. It just takes a few seconds for the extra security. The only other thing is to somehow secure the bloodlines to my wrist or hand. I used to make a gauze cuff and tape the lines around my wrist, but lately, I’ve been taking the bloodlines in my hand and then slipping a length of burn net over my hand (and the tubes). It seems very secure. That’s all I do.

Yes, usually when coming off, the needles are stuck a little. All I do is that while I pull with my fistula hand using the scissor clamp I put on the end of the needle line, I support the needle behind the wings with the fingers of the same hand I’m holding the gauze with. That way, I can’t accidentally pull it out and bleed.

It’s all a lot easier done than explained.

Pierre

We all learn to get by in our own ways I guess…
My skin is sensitive to the normal tape, so I use Yuki-Ban. Anyway, I always lay everything out at the start. THe Yuki-ban gets the end turned over each time, for non-stick, & peeled off into about 7.5cm and 10cm (3/5") strips and placed like little soldiers, overhanging the front of the blue plastic, which my “going-on” kit comes wrapped in. THe shorter ones criss-cross the fistula tabs once they’re in, the longer ones get looped behind them to keep them steady. A couple of others go across their tubes, near the top, to steady them. For this I loop the line back & hold it with my lips. Once I’m on & running, I run tape lengthwise down across all the tape ends either side for extra security and I tape the lines between ‘pinke’ and next finger and along my arm so they cannot be pulled.
Coming off, I use the clamps in my fistula hand, as mentioned (by Pierre?), with the alco-tab & gauze ready in my ‘free’ hand.

Taping does take a little practice so you don’t get the tape all stuck together. Shorter lengths of tape help. I criss-cross the first piece around the butterfly of the needle then tape straight across that with additional tape.

I’m able to pull the needle with my fistula arm hand while holding pressure with my good hand.

I use plastic thin criss-crossed sliced tape for holding needles in place and paper tape to hold gauze in place…all self done myself…no assistance…

PMB wrote:

I’m able to pull the needle with my fistula arm hand while holding pressure with my good hand.

We watched a home patient do this. Does this step make you nervous? One wrong move and there goes the blood. Is there any way to secure the needle before you pull it so it dosen’t accidentally get knocked loose?

I use a 2 3/8 in square tegaderm patch to hold both needles in plus micropore tape to hold the tubing to my arm above the buttonhole sites, also I wear a T shirt and clamp the tubing to the arm of the shirt so it should never be able to pull out . coming off I manage to use my thumb to hold the gauze over the site while I use my first and second finger on the same hand to pull the needle out , sometimes it sticks a bit but never have shot all over the room yet (((knock on wood )))

This is a picture of how I do my taping. It is a very secure way of taping. Appologies for the bad drawing.

http://www.members.optusnet.com.au/eggman007/taping.bmp

Didnt anyone like my drawing? :frowning: LOL

Very nice :smiley:

My computer stopped working last week, and I have no way to access the internet at the moment, except when I can use someone’s laptop for a few minutes,

Pierre

Skinner wrote:

I use a 2 3/8 in square tegaderm patch to hold both needles in plus micropore tape to hold the tubing to my arm above the buttonhole sites, also I wear a T shirt and clamp the tubing to the arm of the shirt so it should never be able to pull out

I’m trying to picture the tegaderm tape down method. I think it was Pierre who said he has used this method also. Is this method as secure as butterflying the needles? When you pull the tegaderm off, can it bump into the needles? If tegaderms work well, they would be a whole lot easier than the butterflying method. Are you saying that you have a tegaderm on each needle? I’m sure the tegaderms are much more expensive than gauze and tape, but if they work well, maybe an item woth paying for out of pocket.

The way you tape to arm and then to shirt makes sense too to prevent needle pull outs.

Amba,
Actually, I did like your drawing. Nothing like a good illustration :smiley: However, the wording does not come through on my puter. Can you write out again what you do? It looks like the butterfly method. I have seen this done several ways in-center. One way is to take tape with gauze and go across the wings first. Then, butterfly over wings with thinner strip of tape. Then come across the whole thing again with one more piece of tape.

Do you tape the needle lines down further down? I have been trying to think of a way to secure the needles for when the tape is removed at the end when needles are pulled. They are just there and unless one keeps perfectly still they could get knocked out. I had thought maybe a piece of tape on the needle lines would secure them prior to pulling out.

I’ve taped like amba does, and the several other ways that dialysis nurses have their own preferences for. However, a Tegaderm is sooooooo… much more convenient. It’s very secure too. I much, much prefer to use a Tegaderm at home. A 10x12 Tegaderm cut in half works great, one half for each needle. Easy on, easy off with one hand.
Pierre

In the next week or so I will take a photo of my taping if I can. Hmm actually, Ill just do a dummy one, instead of when Im actually cannulating. Just remind me if I forget. Ill take the photo in stages to make it easier to understand.

Im not sure if I could trust tegaderm, it tends to roll up on my skin. And it might do it more so because I have so many blankets on while Im asleep and I roll over quite a bit.

Amba wrote:

Im not sure if I could trust tegaderm, it tends to roll up on my skin. And it might do it more so because I have so many blankets on while Im asleep and I roll over quite a bit

We’ve seen the tegaderms used in-center. They look like they hold everything in very well and are so much easier to use as Pierre says. Do you think they would be secure if one didn’t have so many blankets and roll over a lot? Are they extremely expensive or could they be purchased for a reasonable price?

Will watch for your demo!

I’ve read this thread with interest, I think units have their own protocols for taping, & even nurses if they’ve trained somewhere else.
I usually use paper tape, 2 thin 5 wide, 2 thin go under & across the needle holding it down, then wide tape across, if necesary a little gauze under the needle to hold it up, usually my A.
Same for both needles then another piece of tape , number 5 to attach my lines to my wrist.

My current unit don’t have narrow tape, apparantly “its not sticky enough!” I’ve heard it all now! LOL

I usually make a small fold at the end of each tape in order to make things easier at the end of a session.

Nearly had a severe accident today, I’m in unit & the silly nurse forgot to clamp my A needle when disconnecting the line! I was fast enough to picnch the tube thats part of the needle, otherwise there would have been blood everywhere, as it was I just got some on my trousers & the take off sheet! Never wear expensive clothing on dialysis anyway!

The usage of tegaderm intruiges me, I only ever use it for applying EMLA cream before dialysis!

I used to use tegaderm on my permacath, and although it was secure, I wouldnt be able to trust it with the needles. Its winter here at the moment so Ive got heavy blankets and some nights I move alot. Im happy with the way I tape them. Although the venous seems to be leaking slowly overnight for some reason. I thought it might of been bleeding from the local but Ive since stopped using it and its still bleeding.