# Question about IV station at registry



## Chief Complaint (May 18, 2011)

Ive got the practical section of my NREMT-I/99 coming up this Friday and im having a bit of a brain fart when it comes to the IV station.

During my internships i have always had access to Tegaderm to keep the site sterile, i have not started an IV without Tegaderm in quite some time.  

My question is, should i just cover the site with sterile gauze and secure it with tape?  Im assuming that i cant just leave it exposed.


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## LucidResq (May 18, 2011)

I've seen a few sites secured with Transpore/transparent tape alone. I don't really believe this method would have a higher risk of infection compared to Tegaderm. I could be wrong, but I doubt there's any evidence to actually show that anyways.


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## Handsome Robb (May 18, 2011)

For our IV practical, we had all the necessary items to start an IV including a tegaderm. i don't see why you wouldn't be provided with one, not saying it couldn't happen though.


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## Chief Complaint (May 18, 2011)

Gracias for the replies.

The reason i ask is that i was told my one of my instructors that they dont always provide Tegaderm at the station.  I just want to make sure i dont go in assuming that it will be there, and then be stuck.  

Ive seen a piece of tape used in the field to cover the site but im not sure if thats something that they will have an issue with at registry.  So in the absence of Tegaderm, could i use a piece of tape?  Or should i go ahead and cover the puncture site with sterile gauze?


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## phideux (May 18, 2011)

For both the Intermediate and Paramedic practicals I took, they wanted it done the old way. The 2 chevrons of tape on the hub of the catheter, and the line taped down. They didn't have Tegaderm or veinaguards at either practical I took.
On the skill sheets 2 of the steps are the cutting/tearing  of your tape, and taping down the catheter.


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## Chief Complaint (May 18, 2011)

phideux said:


> For both the Intermediate and Paramedic practicals I took, they wanted it done the old way. The 2 chevrons of tape on the hub of the catheter, and the line taped down. They didn't have Tegaderm or veinaguards at either practical I took.
> On the skill sheets 2 of the steps are the cutting/tearing  of your tape, and taping down the catheter.




So it would be ok to just tape the hub down and leave the actual puncture site exposed?


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## phideux (May 19, 2011)

You're not supposed to "just tape the hub down". You put your first chevron of tape around the hub one direction, your second piece around the hub the other direction, a piece of tape over the catheter, and tape down the line. Some testers will allow you to verbalize securing and taping the line, others will want you to do it.


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## Chief Complaint (May 19, 2011)

phideux said:


> You're not supposed to "just tape the hub down". You put your first chevron of tape around the hub one direction, your second piece around the hub the other direction, a piece of tape over the catheter, and tape down the line. Some testers will allow you to verbalize securing and taping the line, others will want you to do it.



I should have clarified, i know how to secure the site with the chevron and all of that.  I wasnt planning on just throwing 1 piece of tape on there!

I guess im just asking if its ok to put a piece of tape over the injection site in the absence of Tegaderm.  Or would that be considered contamination of the site since the tape isnt sterile.


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## ClaymoreCharlie (May 19, 2011)

The national registry skill sheet for iv station is pretty stupid, in my opinion.  One of the steps is to tear tape prior to venipuncture, yet the step for securing can be verbalized.  Furthermore, there is no way that is specified for securing the IV.  When I did my paramedic practical, all I did was rip tape apart and when it came to securing, I threw ONE piece of tape over the hub.  Because we were trained to be verbal about what we are doing, I explained that according to the skill sheet this was deemed an acceptable method.

Of course, skills examiners are supposed to be objective in their documentation, and since some can be subjective, do this at your own risk.  Our medical director was in charge of our skills day and made it very clear to all examiners to be objective when evaluating us.


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## sweetpete (May 19, 2011)

When I took my practical, the paperwork stated that you had to secure the IV with either an "IV securing device" (Tegaderm) or tape, but the tape had to be torn and ready for use prior to the IV attempt.

Nowhere did it state a "Chevron" style fold would be necessary. Probably will be up to the proctor.

Take care,
Pete


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## Chief Complaint (May 19, 2011)

ClaymoreCharlie said:


> The national registry skill sheet for iv station is pretty stupid, in my opinion.  One of the steps is to tear tape prior to venipuncture, yet the step for securing can be verbalized.  Furthermore, there is no way that is specified for securing the IV.  When I did my paramedic practical, all I did was rip tape apart and when it came to securing, I threw ONE piece of tape over the hub.  Because we were trained to be verbal about what we are doing, I explained that according to the skill sheet this was deemed an acceptable method.



I noticed that as well, seems very odd.  Im not going to take the easy way out and just verbalize the tape job.  Seems pretty lazy.  Besides, since the medication administration station is part of the IV station, it will be a lot easier to keep the port steady when delivering a bolus if its secured well.



sweetpete said:


> When I took my practical, the paperwork stated that you had to secure the IV with either an "IV securing device" (Tegaderm) or tape, but the tape had to be torn and ready for use prior to the IV attempt.
> 
> Nowhere did it state a "Chevron" style fold would be necessary. Probably will be up to the proctor.
> 
> ...



The chevron style of taping isnt mandatory, its just a popular method.  I prefer to have a thin piece of tape already stuck to the bottom of the butterfly before i even stick the patient.  Then i just fold it up to provide some stability while i connect the IV tubing.  Thats the way i was taught so it stuck with me.


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## ClaymoreCharlie (May 19, 2011)

Chief Complaint said:


> I noticed that as well, seems very odd.  Im not going to take the easy way out and just verbalize the tape job.  Seems pretty lazy.  Besides, since the medication administration station is part of the IV station, it will be a lot easier to keep the port steady when delivering a bolus if its secured well.



Lol, I more did it to be a smart@$$ than anything.  I also debated using a 60 gtt administration set and putting a pressure infuser on the bag, just to see if I would pass.


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