How do you keep children from pulling IVs?

Specialties Pediatric

Published

Hi!

I am a student nurse, and I am trying to do a research paper on strategies to keep children from pulling out their IVs. I had a wonderful 2 year old patient in my pediatric clinical who pulled out everything that they tried-- IVs, PICCs, etc. It made me wonder what else could be done, because it was beginning to have serious consequences for his care.

I am having a hard time finding any EBP/research information on how nurses deal with this. Splinting is all I have seen, but I have found almost no evidence supporting this practice. I'm surprised and frustrated there isn't more guidance on how to address what I imagine is a not-uncommon problem!

Thanks so much for any help/direction/information you can give me. Even if it is only what you do/have seen done, it would be a jumping off point as I hunt around CIHNAL (ugh).

Specializes in Mother Baby RN.

Sometimes with kiddos, just hiding the line with mesh and gauze is all it takes...out of sight out of mi d. Other times mits work, then splints. Least restrictive to most restrictive. Having parents, aides, and RNs around to distract and redirect works, too.

Specializes in Pedi.

Splints, socks, mesh... anything you can hide them with. Some kids are going to get the line out no matter what you do....

I've seen IV "houses" to protect the PIV. It was basically a clear, hard/rigid plastic dome that fit over the PIV. It fully covered the tubing but left the autoclave (the port that you connect the IV tubing to) accessible. It was far from perfect, but I felt like it kept the kids from accidentally pulling it out when the rolled. Of course, it was also big and bulky, so it was hard to cover up, and problems like wrist or elbow bending would still make you loose access. I.V. House | Protection Over and Above

Specializes in Pedi.
I've seen IV "houses" to protect the PIV. It was basically a clear, hard/rigid plastic dome that fit over the PIV. It fully covered the tubing but left the autoclave (the port that you connect the IV tubing to) accessible. It was far from perfect, but I felt like it kept the kids from accidentally pulling it out when the rolled. Of course, it was also big and bulky, so it was hard to cover up, and problems like wrist or elbow bending would still make you loose access. I.V. House | Protection Over and Above

Yes I've seen those too. They came with a sticker of a dog and that was apparently supposed to remind the kids not to touch it because the dog needs to stay in its house or something...

Specializes in NICU, PICU, PCVICU and peds oncology.

Here are some articles I pulled using "taping techniques for securing peripheral IVs in peds" as my Google search term. I've looked at each of them and think you'll find some useful material.

http://emedicine.medscape.com/article/2008690-overview#a15

http://www.saskatoonhealthregion.ca/about_us/documents/Nursing%20Affairs/IV_and-or_Peripheral_Saline_Lock_Insertion_and_Maintenance-1118.pdf

http://www.infectioncontroltoday.com/articles/2005/02/infection-control-today-case-study.aspx

http://www.acestar.uthscsa.edu/institute/su11/documents/1st%20Smith,%20Andrea%20updt.pdf

http://www2.nursingspectrum.com/articles/article.cfm?aid=12273

Specializes in Acute Care Pediatrics.

We find that simply hiding them like a previous poster said is your best bet.

Oh my goodness, thank you all so much for being so helpful and responsive! I love peds-- in part because it seems to attract the best nurses. Thanks for proving this again! and thank you especially janfrn for all of that work!

Stat lock. Tape a few times in a few places to give multiple pull points. Hide it.

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