Abstract:

Introduction: Vascular access complications are common among hemodialysis patients, although most are not immediately life-threatening. However, inconsistent taping techniques and incompatible detection mechanisms may lead to venous needle dislodgement (VND), which can lead to catastrophic blood loss. Taping technique does not always meet the recommended best practice and there may be no available protocol for new staff.

Methods: Three commonly used taping patterns (the Chevron, butterfly, and overlapping styles) were tested in a mechanical engineering laboratory to determine the forces that each method was capable of withstanding.

Results: While all taping styles were confirmed to have an adhesive force stronger than the inherent force from the venous jet flow of blood, the overlapping style was found to have limited capability beyond this minimum criterion. Both the butterfly and Chevron styles demonstrated excellent holding capability, with elongation of dislodgement particularly noted for the butterfly style, and slightly stronger hold noted for the Chevron style. The Chevron style may be better suited to lateral movements from all directions, due to the taping direction.

Conclusions: We recommend that either the Chevron or butterfly style is used for dialysis needle taping, with the butterfly better suited to home dialysis (where monitors may be used) and the Chevron better suited for in-care patients who may present erratic movements. The overlapping style is not recommended for use.

Reference:

Chan DYF, Dobson S, Barber T. Hemodialysis taping styles and their effect on reducing the chance of venous needle dislodgement. Semin Dial. 2020 Dec 18. doi: 10.1111/sdi.12944. Epub ahead of print. PMID: 33336846.