That’s how I like to do it too, although I call it a mesentary, not a leash ;) What do you think about putting in a purse-string suture with ends hanging loose (to be used later when the tube is removed)?
I asked Kenji about this and he said he didn’t typically use it anyway to close, so his preference was not to bother. I think different people have different approaches and your suggestion is certainly reasonable.
After securing tube, if time permits and all is well with the patient and the others in the ED, I do my best to make the most bizzare taping series. Everyone is generally still watching and I really enjoy the baffled looks I get. Bottom line you can tape it down however u like as long as it works.
One interesting technique I've learned from combat medics/Special Operations medics is after the suture, taking two of the "good" chest seals (not the asherman/bolin, but the super sticky HALO/Hyfin)and basically put one on one side and one on the other and "sandwich" the tube between them. Provides seal and helps hold it in as well. Just not super fun for whoever has to take it off . . . .
James P. - September 4, 2018 11:28 AM
That’s how I like to do it too, although I call it a mesentary, not a leash ;) What do you think about putting in a purse-string suture with ends hanging loose (to be used later when the tube is removed)?
Jess Mason - September 4, 2018 5:27 PM
I asked Kenji about this and he said he didn’t typically use it anyway to close, so his preference was not to bother. I think different people have different approaches and your suggestion is certainly reasonable.
Sean G., M.D. - September 6, 2018 9:52 PM
After securing tube, if time permits and all is well with the patient and the others in the ED, I do my best to make the most bizzare taping series. Everyone is generally still watching and I really enjoy the baffled looks I get. Bottom line you can tape it down however u like as long as it works.
Neil D. - September 7, 2018 6:16 PM
One interesting technique I've learned from combat medics/Special Operations medics is after the suture, taking two of the "good" chest seals (not the asherman/bolin, but the super sticky HALO/Hyfin)and basically put one on one side and one on the other and "sandwich" the tube between them. Provides seal and helps hold it in as well. Just not super fun for whoever has to take it off . . . .
James C. - September 10, 2018 11:20 AM
The most complex procedure in all of medicine, finally demystified.