The ROPE method will get you in trouble at the wound station during the CPNE!

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Editorial Team / Moderator

Lunah, MSN, RN

33 Articles; 13,748 Posts

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 15 years experience.
I couldn't get the parachute method to work for me so what I practiced doing and passed with was this: I opened up the gauze all the way, held it out like a diamond, smoothed it out a little, loosely gathered it into my palm, pulled out one corner of the gauze, folded that corner over, nudged that folded part in the littlest corner of the wound, and fed the rest of the gauze into the wound using a pattern that was like flower petals to cover the majority of the wound.

That's almost EXACTLY what I did! :) I didn't quite open it out all the way, though -- I think I left one side folded over. Worked well for me, and allowed me to control the gauze and maintain good aseptic technique.

firegrrl

59 Posts

Specializes in Cardiac. Has 5 years experience.

OK, I also just took the CPNE and passed using a modified rope technique.....mine wasn't twisted tight by any means, but it helped me to keep control of the gauze. When I went to the CPNE Lab practice thingie, they were teaching the flower method, which I could not figure out at all. I think the main idea is to not have your packing to tight, regardless of the method you use. :twocents:

NC Girl BSN

1,845 Posts

Specializes in Psych, LTC, Acute Care.
OK, I also just took the CPNE and passed using a modified rope technique.....mine wasn't twisted tight by any means, but it helped me to keep control of the gauze. When I went to the CPNE Lab practice thingie, they were teaching the flower method, which I could not figure out at all. I think the main idea is to not have your packing to tight, regardless of the method you use. :twocents:

When is your graduation date?

Specializes in ICU, PICC Nurse, Nursing Supervisor. Has 20 years experience.

lunah ,sue , nc girl...anyone that knows this stuff..

can you look at this and see if this is the round about what of doing this method. when i was taught sterile field i was taught to minimize contact and it sure looks like he is manipulating this gauze....i am extremely worried about this section of the lab. are they looking at the way you put your sterile gloves on or just the actual wound care...

http://www.youtube.com/watch?v=fskgcjke_ra&feature=related

They're looking at all of it.

While I think that he is probably okay, I don't like his technique at all.

First, I would not be prepping my gauze anywhere but over my sterile field.

Second, I don't like the parachute method. I lay in the gauze gently, working from the middle of the wound out towards the wound bed edges, taking very great care not to touch any intact skin - contamination - and not to smoosh it in that way.

I sort of start folding it in, if that makes sense.

Set up your field first. Set your saline to the right of it first, after you've lipped it into the trash. Then take the tape you'll need and tape the edge to the warkspace. Open, from left to right and towards you so your hand doesn't pass over the sterile dressings, the ABD pad, then the 4 x 4 (if there is one), then the dressing itself. Pour the saline onto it, taking care not to pass the dirty bottle or your hands over the field - come in from the side.

Once that is done, clean gloves. Remove the old dressing and roll your first glove over it, then the second. Dispose of it where they have told you biohazardous waste goes.

Sterile glove donning time.

Preparing your gauze time. Pack the wound. Cover with the 4x4 and then ABD. Tape and initial and time and date.

Don't stress this. You KNOW wound care.

:)

Editorial Team / Moderator

Lunah, MSN, RN

33 Articles; 13,748 Posts

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 15 years experience.

If I recall correctly, Redden posted that to demonstrate how to do the parachute part -- he knows that his videos aren't perfect, which is why he posted them -- for us to give him feedback.

And yes, they look at everything! I don't like the parachute, either ... mostly because I can't do it very well. :D

ougreene

123 Posts

Specializes in Nursing home, Research, Pulmonary.

i do have to say one thing (well maybe two:twocents::twocents:..)...in the cpne, to me, it appeared that the gauze i used out of the tub seemed thicker ply than what is supplied in the skills kit gauze tub. just being thicker seemed to help cover the wound easier.

i tell you also ....i practiced this skill alot and you know i found there is no one sure way to repeat exactly the same thing each time.....i ended up opening the gauze up somewhat and starting at the most distal point on the wound and sort of zig zagging down over the wound nice and fluffy.....

gail:D

NC Girl BSN

1,845 Posts

Specializes in Psych, LTC, Acute Care.

Texas,

I used the parachute method but I did not pack it like the video. I started at the smallest peak and worked my way to the top. Really a kept my non dominant finger at the bottom and just kinda layed the rest in the wound. I didn't manipulate it as much as the video and I was fine.

dsd2sis

3 Posts

Reading all these posts are making me nervous. I thought I had this station down, but now I'm doubting myself. I have trouble with the parachute method so I fluff the gauze and start at one end of the wound and lightly pack it. There is no twisting going on but I don't want the CE to confuse my method with the rope. I test this Friday 2/13 so I better get busy.

Specializes in LTC, Acute Care.

I found that the gauze I had with the skills kit and another boat of gauze I bought were either much bigger or my skills bag wound was smaller than the ones we used at Racine. I was so freaked out about this wound because I couldn't seem to fit all the gauze in at home in practice. However, at the actual lab station it was a breeze. I would take the gauze, unfold it almost all the way, fanfold it in my nondominant hand, and fluff and fanfold or smush it in. It was a piece of cake. The CE sat at the side of me doing my thing and at the end stood up and removed half of the dressing to make sure the gauze was in. However, she actually grabbed a part of the gauze when she removed the dressing, so a part of it winged out onto the skin. She passed me on it. :)

changeofpaceRN

545 Posts

I didn't really do the rope method but I did something very similar.. the parachute method just doesn't work for me. As I was unfolding the gauze, I put it all in one hand and took out the an end piece. I turned to my CE and said "I'm folding this like a package and NOT twisting" I went on my merry way packing and passed. My 2 cents.. don't twist for anything. You can fold, turn, ect but avoid the twist :-)

Raggedy Ann

756 Posts

Specializes in Med surg and Psych. Has 9 years experience.
reading all these posts are making me nervous. i thought i had this station down, but now i'm doubting myself. i have trouble with the parachute method so i fluff the gauze and start at one end of the wound and lightly pack it. there is no twisting going on but i don't want the ce to confuse my method with the rope. i test this friday 2/13 so i better get busy.

rooting for you! best wishes and good luck! traci;)

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