No bandaids

prmenrs, RN · Jun 26, 2012

Try using "Kling". If you add a tiny cotton ball, it will help, too.

TiffyRN, BSN, PhD · Jun 26, 2012

I have not heard of the "no adhesives" rule in the NICU. I would be interested in knowing how you secure tubes. I do know some creative ways to greatly decrease use of adhesives, I tend to be a minimalist, but there is still some adhesive involved. I really sympathize with the kids, I react to most bandage adhesives.

As far as band-aids, these are rarely used in our unit. For heelsticks, we wrap the foot in gauze, but not the traditional all-cotton kind you guys are probably using. We use the mira-sorb brand, which I think is a blend of rayon-polyester that stretches and with very mild tension it is easy to wrap around a heel. In fact, part of my routine is to put a heelwarmer on, wrap the gauze around the heelwarmer (because kids always kick those off), then I set that gauze to the side and re-wrap the freshly stuck heel with it when I finish collecting the specimen. If you neatly secure it, it won't come off until you take it off. For the tiny ones (under 800 grams), I will cut the gauze in half or they wind up looking like they have a lower leg cast on.

cally527, RN · Jun 26, 2012

http://www.shop3m.com/3m-self-adherent-wraps-5144g1ltsx.html

I would think that this would solve the no adhesive problem. It works really well, comes in a variety of colors, is stretchy, breathable, sticks to itself but not to skin or hair, can provide enough pressure to stop bleeding without cutting of circulation and finally, it allows movement without getting loose.

sherirn127 · Jun 26, 2012

Wow... Thanks for the responses. We can't completely out rule adhesive. We still have to tape down tube but we place deuodem under the tubes then tegaderm over that. This way we are not removing tegaderm from the skin every time the tube has to be adjusted or replaced. I tried to google Kling but there are alot of things out there with that name. I looked into the self adhesive elastic bandages but I can't find anything to say its ok to use in neonates.

prmenrs, RN · Jun 27, 2012

Cardinal Health:SOF-KLING™ Conforming Bandages

Coban would work, too.

TiffyRN, BSN, PhD · Jun 27, 2012

The gauze that prmenrs linked (sof-kling) looks like the gauze we use, but instead of being in rolls, they are just tri-folded 4X4's. The ones we use the most are packages of non-sterile that are probably a foot long, but we give each kid a 1/2 package when they are admitted. We use them for everything.

meanmaryjean, DNP, RN · Jun 27, 2012

In the wonderful world of medically-complicated peds homecare, our families collect (during hospitalizations) those little velcro wrist restraints. Cut off the twill tape, and they are EXCELLENT non-adhesive holders for gauze, pulse oximeter probes and all SORTS of things. They are adjustable, padded and re-usable. They are also GREAT for hanging a syringe for tube feeds/ burp at any level you please. (I would say "I love restraints" but that would sound creepy)

babyNP., APRN · Jun 28, 2012

No adhesives?? how do you put on ecg leads then or pulse ox??

We use a type of bandaid that doesn't stick very well (a full size one) but I fold a piece of sterile gauze where the stick is and it's enough to keep it on. If there's something really stuck there on the patient, I'll use an adhesive removal wipe.

bmsrn · Jun 28, 2012

We limit the use of adhesives. How do you secure a PIV or dress a PICC with no adhesives? For heelsticks, we have what we call OB sponges. They are cotton squares that stretch and stick to themselves. For kids that kick a lot, I just tape over the OB sponge. We still have band-aids in our unit. I only use them for immunizations, and by that time the babies are bigger and going home.

Bortaz, MSN, RN · Jun 29, 2012

I don't like those on my babies. I'm constantly having to remove it because lab techs or RTs frequently wrap it too tightly. Often I'll do my first assessment and find bluish toes from the too-tight wrap.

TiffyRN, BSN, PhD · Jun 29, 2012

Often I'll do my first assessment and find bluish toes from the too-tight wrap.

I'm not sure which method you are referencing, I know with the stretchy gauze we use you still need to be careful. It doesn't have to be tight at all, the few times I've had a heel bleed through the gauze, adding a partial cotton ball right on the poke then rewrapping with stretchy gauze will be just enough pressure to stop that heel's bleeding.

Of course we know the kids that bleed through the gauze are always they ones that refuse to bleed. . . until you have collected the specimen (which will be hemolysed and clotted of course). But, that's another topic for another day. . .