Tegaderm and tape dressing on VERY diaphoretic patient

[Beanyamean]

Today in the ER I assisted with a patient who was extremely diaphoretic. After my coworker inserted an IV into the patients hand. They called me over for assistance as they were unable to apply any type of dressing. The patient was extremely diaphoretic. After trying Tegaderm and various types of tape. We were unsuccessful at securing the IV site. After much trial and error, I was finally able to secure the IV site by shaving the IV site, using a shield barrier prep, alcohol swabs, Mastisol, Steri-Strips, and Tegaderm. Does anybody have any other easier ideas as to what to do in the case of an extremely diaphoretic patient?

[mclennan, BSN, RN]

I/O. If multiple attempts to secure an IV fail and you have the ability & equipment, do an I/O.

[MunoRN, RN]

I find even the sweatiest patient can't sweat through a couple layers of barrier wipes. I clean with alcohol wipes (mainly because it will dry before the patient can sweat too much again), then barrier wipes, then the tegaderm. If that fails, the white steri strips seem to almost stick better in the presence of sweat.

[chrisrn24]

What about lightly wrapping the site in kerlix or something similar?

[Anna Flaxis, BSN, RN]

Alcohol wipes, then skin barrier or benzoin, then the tegaderm, then Kerlix/Kling and/or Coban.

[SionainnRN]

Coban, coban and more coban!

[Amy Bruinsma]

I use tincture of Benzoin, works all the time

[Beanyamean]

Thanks for all the great replies! Not sure why I would ever start an I/O just because I was having trouble dressing a perfectly patent peripheral IV... My institution does prefer that you are able to completely view the cannula. I was able to get it secured well. Unfortunately the hospital I work at is not supplied as well as it should be, so we have to improvise and make do with what we have. But you guys sure had some great advice!

[Esme12, ASN, BSN, RN]

Not all facilities allow IO for non emergent/code situations. Not all facilities have co-ban.....benzoin, kling/kerlex, steri strips, and an ACE wrap can serve well.

[Beanyamean]

I like mastisol because it is something like 10 times "stickier" than benzoin, and it comes in a perfect applicator. We do have Kling/kerlix, Coban, ect. But it seemed to work really well with mastisol and tegaderm. I just replaced the chevron tape with steri strips. Worked like a charm. It was the pts primary IV and we "require" the cannula to be visible. Not a cheap way to do it, but it worked! I feel bad for the nurse that has to remove it all.

[nurseprnRN, BSN, RN]

Benzoin, oh yeah. Oldie but goodie. Be sure to wait until it's tacky-dry to put on the tape, or you'll be wondering why anyone would use it for anything.