Anesthesia & Analgesia:
Letters To The Editor: Letters & Announcements
Department of Anesthesiology, Surgery, and Physiology
University of Mississippi School of Medicine Jackson, MS
To the editor:
Currently, most IV and arterial lines are secured with adhesive tape, sutures, and dressings. These do not always provide enough security, however, and displacement still occurs. This is particularly important for patients requiring long-term care, as many have difficult IV and arterial access. Disoriented, agitated, or restless patients who are prone to pull on inserted lines also present a common problem. Finally, rambunctious children represent a third category of vulnerable patients.
We would like to introduce a method used at our institution to optimize security of inserted lines and minimize the need for multiple subsequent venous and arterial punctures. We use a pressure bag intended for invasive pressure lines. After inserting, dressing, and taping the IV or arterial lines, we place the patient’s extremity into a pressure bag, which is then inflated to a firm but nonocclusive level. A pulse oximeter probe is placed to ensure adequate blood supply and perfusion of the extremity (Fig. 1). This method serves two purposes as it prevents patients from destroying lines and secures the lines in place. We have not encountered any side effects or problems using our method in these patients. A possible limitation is the size of the extremity in overweight patients or small children (this could be possibly handled by varying the size of the bag).
In conclusion, we found that use of a pressure bag to be a convenient, safe, and easily applied method to secure IV, arterial, or other lines on extremities of agitated, long-term care, or pediatric patients.
Olga Blakley, MD
George Mychaskiw II,, DO