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stonemd

stonemd

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anyone share experience with medical superglue to secure catheters, sepecially thoracic epidurals. Securing cath at exit site might reduce leakage, keep tegaderm well adhered and prevent cath from 'migrating' out.
 
That's a very expensive way to secure a cath. Why not just try benzoine? It's sticky and smells great.
 
I tried that with dermabond a few times in residency, as that was "the thing" for a few months. It worked, but it costs a lot more (so we were told), and we really didn't have many problems with lost catheters before trying it out. On the rare occasion that we had a very long duration indwelling peripheral catheter that started leaking, dermabond did tend to seal the tract, and prevent further leaking for a few days until the catheter was changed.
 
Leakage from a peripheral nerve catheter is usually due to too much volume and turning rate down usually does the trick without sacrificing much if block is solid
 
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We used to have these aerosol cans of sticky spray pink stuff for securing epidurals. Worked great. No one seems to know what happened to that stuff. For all I know it was 3M construction adhesive from the paint aisle at Lowe's.

Now I juse use benzoin swabs, or the little Mastisol ampules.
 
our practice with benzoin/mastisol covered by tegaderm still has some fall out early.
It think the cause is leakage of fluid along the insertion track.
Tegaderm loosens as fluid accumulates beneath.
Pt slides around in the bed, now loose catheter slides out bit by bit ...

I tunnel all PNB caths and dont have a problem with these coming out

I think tunnelling epidurals might decrease leakage but sometimes difficult in slender patients with little SQ in thoraic region.

The dermaflex is ~ $8 a dose, so if that would save a catheter reinsertion it definately would be worth that cost.
 
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pgg said:
We used to have these aerosol cans of sticky spray pink stuff for securing epidurals. Worked great. No one seems to know what happened to that stuff. For all I know it was 3M construction adhesive from the paint aisle at Lowe's.
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Click to expand...

Vidrape spray adhesive. Very sticky and smells awesome!! We still have it.
 
pgg said:
We used to have these aerosol cans of sticky spray pink stuff for securing epidurals. Worked great. No one seems to know what happened to that stuff. For all I know it was 3M construction adhesive from the paint aisle at Lowe's.

Now I juse use benzoin swabs, or the little Mastisol ampules.
Click to expand...
nimbus said:
Vidrape spray adhesive. Very sticky and smells awesome!! We still have it.
Click to expand...
That spray was the bomb. From what I've heard, it's some JC BS about it being flammable. 🙁
 
16g angio and tunnel it through the the SQ. no more issues. Very inexpensive. Better to lay on than the plastic catheter securing devices.

I place the epidural cath, do a test dose and while waiting to see reaction I take the connector off the end of the cath and pass it through the tunneled angio. I tunnel the angio by sliding the cath off the needle then passing the needle laterally SQ about 3cm starting right up next to the epidural cath. Then I slide the angio cath carefully over the end of the needle and pull the needle back through the SQ tissue leaving the angio tunneled. Next I pass the epidural cath through the angio and then slide the angio back out. It is super easy and secures the catheter better than anything I've tried.
 
Thanks for the tips, I tunnel with the stylet then touhy needle.
I guess tunnel and/or glue are the best options for long term viability of catheters
I will let you know our experience
 
And I thought this was going to be a thread devoted to huffing glue. How disappointing!
 
dermabond and 2 tegaderms for inter scalene cathethers, which I find are the most prone to wandering and pulling out. It works about 80% of the time, but since the catheter is only a few mm below the skin, not much there for traction. Are people tunneling their inter scalene catheters too?
 
If I did them (meaning, if I saw a reason for placing one) then, yes, I would tunnel.
 
I have done lots of interscalene catheters and always tunnel all PNB caths. Decreases leakage and therefore helps keep the tegaderm firmly attached to the skin. I dont have any problem with PNB caths coming out.
 
We still use the red/pinkish sticky spray that smells just like a nail salon to secure epidural catheters. Go through it like a sorority girls do diet coke. Spray Pt's back at catheter insertion site and then up to shoulder, use sterilely gloved hand to press catheter on sticky sprayed skin then apply teg and run 2inch tape over catheter + sticky spray up to Pt's shoulder. Been the method taught at my residency program for last few years
 
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