Securing UVC/UAC?

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What do you guys do to secure your umbilical lines? The NNP/doc sutures the lines in, and then we have these bridge things that adhere to the baby's belly and hold the lines in place. They're made of this foam stuff. We put strips on duoderm on the baby before the bridge. I had to take a bridge off of a baby (26 weeks) the other day, and despite the duoderm, his skin was torn. Does anyone else use the bridges? Do you not use them on the micropreemies? Do you use something else?

Specializes in Neonatal ICU (Cardiothoracic).

here's something I used once. The duoderm-type material sticks to the skin, and you fold up both plastic sides, sandwiching the catheters inside. Check out the photo gallery.

http://neotechproducts.com/neobridge-umbilical-catheter-holder-p-37.html

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Specializes in NICU.

I'm still not seeing it ..... I think it's something I'd have to see with my own eyes lol.

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Specializes in NICU.

We just suture them for the micros, and we might put a little bit of Tegaderm on a bigger baby that has grabby hands....but that's it.

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Specializes in Neonatal ICU (Cardiothoracic).

I spent some time trying to draw it out on my screen, but it didn't work.

Image the top and side view looking like an "H." You basically take a long-ish piece of pink tape (narrow) and visualize it divided into 4ths. Fold the middle two 1/4 sections sticky sides together so you have a flat, non-sticky piece pointing up, and outer parts sticky side down . You put one of these on each side of the umbilicus, with the non-sticky flat piece pointing straight up, and the sticky part stuck flat to the baby's abdomen. It looks like this once taped to the abdomen IuI (u= umb) Then you stretch a piece of tape across between the 2 "bridge posts," I--I and loop your lines up, around, and back down while sticking it to the exposed tape. Then you cover the exposed side with another piece of horizontal pink tape.

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Specializes in PICU/NICU.

We have always used the loop with the tegaderm.... I REALLY like it! And have not lost one yet.......

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Specializes in NICU.

Our practitioners suture the lines in, we make a loop with the remaining line and tegaderm it down. I think this is easier on their skin and it makes it easy to see measurements.

In our unit ed area there are old guides and protocols that show the bridging method, I guess they did that routinely a few years ago before switching to all tegaderm.

We also secure our IV sites with a piece of tegaderm before we tape and board it, allows easy visuals to catch infiltrates early on.

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Specializes in Level III NICU.

We have manufactured bridges. I'll try to remember tomorrow to look and see what company makes them and maybe I can find a picture online somewhere. Basically in the package they look like an H. The 2 sides of the H stick on either side of the umbilicus, and then the middle part has 2 "wings" that have adhesive on them. The lines go in the middle and the wings fold over and stick to themselves. The problem I had was the 2 sides of the H (stuck to 2 strips of duoderm on the baby) pulled skin off. I've never had that happen. This baby was only a day old, and a 25 weeker. Usually lines stay in for about a week or so, and then when they are removed, the skin is not as fragile. I guess that was the problem, the baby's skin was still pretty gelatinous. I probably wouldn't have put a bridge on in the first place, we typically don't for the really tiny ones. The lines are sutured in, and the babies aren't usually to wild at that point. Anyway, the baby's belly looks good now.

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Specializes in NICU.

Ok, I can kinda picture it now .... sorta. What's the advantage of using something like that though?

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Specializes in NICU.

Our lines are always sutured in by the MDs. We used to always use the bridge method on babies

Our current method: Tegasorb (in a thick "u" shape around the umbilicus), then "loop each line, secured w/ a steri-strip, then a piece of tegaderm (in the same "u shape"). Our infection rates decreased a lot when we switched to only using this method.

If we have a really small baby who has bad skin, we can still use the bridge method.

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Specializes in NICU, PICU, educator.

We loop it on the abdomen and use op-site to hold it down. If it is a ELBW kid we just leave it. All lines are sutured in when they are placed.

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Specializes in NICU.

We had one neo who insisted on bridges, while the other one preferred tegaderm. It didn't seem to matter what we preferred!

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any research out there to back up either of these methods?

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