TAPING TECHNIQUE (TAPING WITH CARE)

Course Description This course focuses on protocols for taping and use of dressing in IV Therapy

General Objective Discuss the protocols, dressing and taping technique in IV Therapy

Course Content Hand Hygiene Management of sharps Hazardous materials and waste

Use Personal Protective Equipment (PPE)

How to optimize adhesion without damaging patient’s skin: 1. Clean and dry skin

Remove substances that contain oils and moisturizers – tapes will not stick well if skin is oily and contains moisturizers like lotions.

If the skin is oily – please use mild soap and water to remove excess oil and pat it dry. Don’t rub the patient’s skin. Ask the patient if they put lotion on their skin before inserting an IV. Seek permission from the patient that we need to remove the lotion and explain its purpose.

Alcohol wipes may be used, but use it with care. Alcohol causes dryness of skin. Use sparingly in cleaning the patient’s skin.

If using skin prep solution like alcohol or iodine – allow it to dry completely before applying tape to avoid chemical injury. It only takes 30 seconds for the alcohol to be dry on the skin and 2 minutes for the iodine.

2. Minimize touching of the adhesive Each time the tape touches another surface, a little of its adhesive gets used up.

Limit the length of time the tape strips are exposed to air.

3. Use sufficient pressure to the tape

The skin has hills and valleys. That is why, it is important to gently firmly stroke along the tape and allow the tape to be in contact with more surface on the skin.

Tape is pressure sensitive. The technique to adhere the tape on the skin is rub-down pressure. Place the tape from center out by rub down pressure. (Press tape from center out evenly and firmly.)

4. Cover adequate surface area with the tape In securing a dressing, have at

least ½ inch or 1 inch tape that adheres on the patient’s skin. This decreases the tendency of rolling the edge of the tape or accidental removal of dressing which is very critical for patients with hemorrhage (or bleeding).

5. Obtain full contact between tape and skin The tape should have full contact

on the tubing to avoid moisture. Minimize wrinkles and gaps

TAPING TECHNIQUE PROTOCOL a. IV (Intravenous) LineTechnique: Sterile Technique (one hand – without notch dressing; 2 hand – with notch dressing)APPLICATION:

a. Prep the catheter site according to your facility’s protocol. Let all prep solutions dry completely.

b. Open the package, remove the sterile dressing

c. Remove the liner from the dressing, exposing the adhesive surface of the dressing. Center the transparent portion of the dressing over the insertion site.

d. Line up the notch in between the port. Apply the dressing, notch until the base

of the port. Press the transparent portion of the dressing into place.

e. Pinch the film together under the catheter. Do not stretch the dressing during application

f. While slowly peeling off the paper frame, smooth down the dressing edges with your fingertips

g. Smooth down the dressing from the center toward the edges by doing rubdown

pressure.h. Stabilize extensions/tubings using lift

method, using transparent tape.

REMOVAL: a. Remove any tape strips applied

on top of the dressing. b. To aid in lifting a dressing edge,

use the documentation label or secure a piece of medical tape to one corner and rub firmly.

c. Support the skin and catheter with your fingers while removing the dressing.

Low and slow: using the label or tape tab, slowly peel the dressing from the skin. Fold the dressing back over itself rather than pulling it up from the skin. Remove the dressing from the hub toward the insertion site.

Stretch release: Grasp one edge of the dressing and gently pull it straight out to stretch and release adhesion.

b. NGT (Naso-Gastric Tube) a. ADULT (age range)

Technique : 2 Split Chevron Technique Tape: Silk Tape (Sensitive Skin) or Cloth Tape (Normal Skin) Size: 1 inch APPLICATION a. Prep the catheter site according to

your facility’s protocol. Let all prep solutions dry completely.

b. Cut or tear the tape at least 4 inch in length.

d. Place untorn portion on the nose. Gently apply rubdown pressure, to maximize adhesion. End of the torn portion must be at the tip of the nose. e. adhere first “split” of tape down the center of tubing. Fold the end to form a tab.(For easy lifting when changing) f. Wrap second strip around tubing. Fold the end to form a tab. g. A reinforcing tape strip may be applied over the untorn section. (optional)

REMOVAL a. Last to apply first to remove. b. Start to unwind the tape from the tube

(2nd wrap) c. Remove the tape placed straight on the

tube. Spread the edge then peel until the tube is free from the tape.

d. Using one of the peeled tapes, stick it on the edge of the untorn portion (middle) to lift the edge.

e. Remove the tape on the tip of the nose, downwards low and slow as you support

the skin.

b. PEDIA (age range) Technique: 2 Split Chevron Tape: (Recommended: Silk Tape

or High Adhesion Paper Tape – Hypoallergenic and gentle feature)

Size: ½ inch a. Prep the catheter site

according to your facility’s protocol. Let all prep solutions dry completely.

b. Cut or tear the tape at least at least 1 – 2 inch in length.

c. Split tape lengthwise into two sections, leaving an untorn

section at the top. (1/2 inch) d. Firmly adhere first “split” of

tape down the center of tubing. Fold the end to form a tab.(For easy lifting when changing)

e. Wrap second strip around tubing.

f. A reinforcing tape strip may be applied over the untorn section.

c. ET (Endotracheal tube) a. ADULT (age range)

Technique : 2 Split Chevron Technique Tape: Silk Tape or Cloth Tape Size: 1 inch APPLICATION a. Prep the catheter site according to

your facility’s protocol. Let all prep solutions dry completely.

b. Cut or tear a 6 inch tape (length) c. Split tape lengthwise into two sections, leaving an untorn section of 3 inch. (1 inch) d. Firmly adhere the untorn portion on the corner of the mouth where the ET tube is. Apply rubdown pressure, to maximize adhesion. e. Place the split tape portion on the upper lip/lower lip (alternating sites, depending on the patient’s oral-skin status). Form a tab at the edge of the tape f. Wrap second strip around tubing- 3 loops. Form a tab at the edge of the tape.

REMOVAL a. Last to apply first to remove. b. Lift the tape from the upper or lower lip , low and slow considering the hair growth c. Using the removed tape, stick it to the edge of the untorn portion to lift the edge. Remove it low and slow following the direction of the hair growth. d. Remove the tape looped from the tube, gently.

b. PEDIA (age range) Technique: 2 Split Chevron Tape: (Recommended: Silk Tape or

High Adhesion Paper Tape – Hypoallergenic and gentle feature)

Size:1 inch APPLICATION

a. Prep the catheter site according to your facility’s protocol. Let all prep solutions dry completely.

b. Cut or tear the tape at least 2-3 inch in length.

c. Split tape lengthwise into two sections, leaving an untorn

section. (1 inch) d. Firmly adhere the untorn

portion on the corner of the mouth where the ET tube is.

e. Place the split tape portion on the upper lip. Form a tab at the edge of the tape.

f. Wrap second strip around tubing. Form a tab at the edge of the tape.

REMOVAL a. Last to apply first to remove. b. Lift the tape from the upper or

lower lip low and slow considering the hair growth

c. Using the removed tape, stick it to the edge of the untorn portion to lift the edge. Remove it low and slow following the direction of the hair growth.

d. Remove the tape looped from the tube, gently.

d. Dressing Tape: Stretchable tape a. When compression is needed: Compression should come from

multiple layers of the dressing material. a. Place first section of tape

without tension onto skin on one side of the dressing.

b. With one hand, secure tape on one edge of the dressing, while slightly stretching next section of tape over the dressing.

c. Secure tape on opposite edge of the dressing.

d. Press remaining tape onto skin without tension.

APPLICATION a. Prep the catheter site according

to your facility’s protocol. Let all prep solutions dry completely

b. Choose the desired type of tape (paper or cloth), cut or tear appropriate size

c. Cut or tear suitable length. Make sure to have at least ½ inch to 1 inch border when applying the dressing

d. Form a tab (considering direction of the hair growth). Lay one side, apply rub down pressure then do the same with the other side. Avoid stretching the tape and putting pressure.

e. Ensure there’s a complete seal on the dressing. If there’s a need to overlap tapes, ¼ inch overlap is recommended.

e. Drains Tape: Stretchable tape, Silk Tape or

Cloth Tape APPLICATION:

a. Prep the catheter site according to your facility’s protocol. Let all prep solutions dry completely

b. Split 4x4 sterile gauze and place one around the drain

c. Place the second gauze with slit around the drain, opposite side.

d. Split a 2inch cloth tape and place one around the drain

securing both the drain and the gauze. Repeat on the opposite side.

e. Cut or tear 4 inch of the same tape to serve as a platform, form a tab at the edge(where the hair growth direction is). Apply with rubdown pressure

f. Cut or tear 3 inch tape. Perform lift method as you secure the drain tube

REMOVAL: a. Remove any tape strips applied to

the tip of the dressing toward the drain site.

b. Separate the tape splits as you release the drain and the dressing.

c. Repeat on the opposite side d. Avoid skin trauma by peeling the dressing back on itself, rather than pulling it up from the skin.

Consider hair growth. Remove the tape low and slow as you support the skin

f. Foley Catheter Tape: Silk Tape or Cloth Tape APPLICATION

a. Prep the catheter site according to your facility’s protocol. Let all prep solutions dry completely.

b. Cut or tear 4 inch tape (length)

c. Form a tab. Place it on the area where you need to anchor

the catheter. Apply rubdown pressure to optimize

adhesion d. Cut or tape 3 inch tape(length).

Form a tab. Lay one side on top of the platform. Form a lift as you tape the catheter (roll to the other side then seal) then lay the remaining side. Apply rubdown pressure on both sides.

REMOVALa. Last to apply first to removeb. Remove the tape on top of the

platform. Start from one side then proceed to the next one

c. Lift the tab (side where the hair growth is) then remove the tape low and slow towards the hair growth while supporting the skin.