Good approach for a medical student or junior doctor. It's simple and secure. In reality you want to be able to seal the hole once you take the tube out. The soweto tie is ideal for this and also only requires 1 suture. Also 2/0 suture is gonna snap if you not careful, 1/0 100cm nylon with colt needle is most practical I find.
Awesome video but I literally just used this 20 minutes ago and as soon as the patient coughed their Tegaderm blew up like a balloon. The seal was maintained and I reinforced all the edges with bulky foam tape, but I'm not sure if the coolness is worth the potential for it popping when the patient is upstairs. It was readily deflated with firm, gentle manual pressure btw.
+A Smith With regard to dressings, it is exceedingly rare for people to react to Tegaderm, and it's one of the most widely used dressings in Australia for intercostal drains, IV sites, and post-op wound dressings. The benefit is that it's transparent, so you can see if there's bleeding or early signs of infection and it can easily be changed daily. If you'd like to make a video showing your preferred dressing technique I'd love to see it.
Your patient would be kicking you to the ground for moving that tube so much. I wouldn't consider this dressing as how could I change the dressing each day so I could asses the drain site? (When we get patients from regional hospitals with ICCs that haven't been dressed in days, they always have pus at the site.) And how do you take a dressing like this off without causing much pain and discomfort to the patient? I would be VERY reticent to dress an ICC like this
+A Smith I move the tube more for demonstration purposes in this video, but in reality I've never been "kicked to the ground", even with moving the tube. Even without tube movement it's a painful procedure, so I use a lot of local anaesthetic (including injecting into the pleural space) and provide adequate parenteral analgesia (eg fentanyl/morphine/ketamine) +/- sedation (eg ketamine or midazolam) prior to starting, which actually makes insertion easier. If your patient is flinching, vocalising, or coughing during the procedure the intercostal muscles contract and the intercostal space becomes smaller, which can make insertion very difficult/impossible, so a relaxed, well analgesed patient is essential prior to insertion (unless they are critically unwell, in which case just use a lot of local anaesthetic).
Good approach for a medical student or junior doctor. It's simple and secure. In reality you want to be able to seal the hole once you take the tube out. The soweto tie is ideal for this and also only requires 1 suture. Also 2/0 suture is gonna snap if you not careful, 1/0 100cm nylon with colt needle is most practical I find.
Thank you this is the best video I have seen without having to do the old purse string trick! Excellent!
Thank you for this information. I was looking for a great way to secure a tube and found what I needed!
Awesome video but I literally just used this 20 minutes ago and as soon as the patient coughed their Tegaderm blew up like a balloon. The seal was maintained and I reinforced all the edges with bulky foam tape, but I'm not sure if the coolness is worth the potential for it popping when the patient is upstairs. It was readily deflated with firm, gentle manual pressure btw.
Ever try a purse-string or a half mattrass?
@@Harlem55 no but I'm open to suggestions
Is there any evidence base supporting this dressing method over other method like gauze+mefix?
Thank you for the video
Excellent.
Very interesting.
excellent Andy
excellent video, thank you!
Any info on your diy chest tube sim there?
ahhh, u used tegaderm, haven't seen that
love the tegaderm sandwich!
Also, I would be concerned about skin reactions from that dressings
+A Smith With regard to dressings, it is exceedingly rare for people to react to Tegaderm, and it's one of the most widely used dressings in Australia for intercostal drains, IV sites, and post-op wound dressings. The benefit is that it's transparent, so you can see if there's bleeding or early signs of infection and it can easily be changed daily. If you'd like to make a video showing your preferred dressing technique I'd love to see it.
Your patient would be kicking you to the ground for moving that tube so much.
I wouldn't consider this dressing as how could I change the dressing each day so I could asses the drain site? (When we get patients from regional hospitals with ICCs that haven't been dressed in days, they always have pus at the site.)
And how do you take a dressing like this off without causing much pain and discomfort to the patient?
I would be VERY reticent to dress an ICC like this
+A Smith I move the tube more for demonstration purposes in this video, but in reality I've never been "kicked to the ground", even with moving the tube. Even without tube movement it's a painful procedure, so I use a lot of local anaesthetic (including injecting into the pleural space) and provide adequate parenteral analgesia (eg fentanyl/morphine/ketamine) +/- sedation (eg ketamine or midazolam) prior to starting, which actually makes insertion easier. If your patient is flinching, vocalising, or coughing during the procedure the intercostal muscles contract and the intercostal space becomes smaller, which can make insertion very difficult/impossible, so a relaxed, well analgesed patient is essential prior to insertion (unless they are critically unwell, in which case just use a lot of local anaesthetic).