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.

Does the tegaderm cover the umbi stump or leave it open?

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Specializes in NICU, adult med-tele.
Does the tegaderm cover the umbi stump or leave it open?

Open. Moisture+occlusive dressing =:barf01:

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Specializes in NICU III/Transport.

Here's a simplistic drawing I found of a bridge: http://www.cs.nsw.gov.au/rpa/neonatal/html/images/Image10b.gif

My current hospital uses thin duoderm to abdomen and looped lines secured to duoderm with tegaderm (like a lot of others have described).

My favorite hospital used a "belly band" and secured the lines to that with tape. We'd tie umbilical tape in a loose circle around the babies waist, then secure the lines to the band with a piece of cloth tape labeled with a V or A. Very secure with no tape/adhesive on the skin at all, and easy to remove lines individually.

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Specializes in NICU Level III.

Okay, I'm at a different NICU than from the first time I posted. We suture them in here then Tegaderm them...to different sides of the umbilicus usually...great for pulling ONE out at a time. I love it.

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I don't think Tegaderm or pink tape or really any tape should be put on any micro-premie skin. We have something called a "Hold-a-line" which is made out of the Duoderm stuff that does not tear the skin when removed. The UVCs/UAC's are sutured in, and then secured with a loop with the hold-a-lines.

Is everyone using the "taffy pull" method of removing Tegaderm? That is the best way to avoid skin tears.

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Hold-a-Line umbi catheter holders made out of the Duoderm stuff are the safest and the most gentle on the skin. The "bridge" or "goal posts" made out of the pink tape were what we used in 1983 when the smallest babies we had were 1000 grams. These holders are so much better for the fragile skin.

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Specializes in ICN.

The lines are sutured in and then we make a 'goalpost' (the little bridge) with a base of hollihesive and then the clear micropore tape to form the goalpost, with the UAC and UVC in different little folds of the tape to keep them separate. This works really well, and rarely causes damage to even the tiniest preemie's skin.

Dawn

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Specializes in NICU.
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?

We use the same type of bridge securement device that you describe. Our doctors do suture the UAC/UVCs in place, then they are looped separately when they are taped. We use the bridge device on all babies with UACs, even our micro-preemies. With a 26 weeker with very friable skin, it helps if you use warm water on gauze to gently peel the duoderm off the baby's skin. No matter how careful you are, you may see some skin tearing on these micro-preemies when duoderm or tape is used on their skin.

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