Footie

• One of the goals when placing an I.V. catheter is to ensure that the catheter does not come out, which is a fairly difficult task when you are hitting a moving target.
• So first you have to place your catheter, tape it in, and make sure your tape is secure but not too tight.
• Determining how tight “too tight” is, is not easy.  It is dependent on the placement of the catheter in the leg, if the catheter is positional, if your patient is heavy, or has stocky or short legs.
• “Paddle foot” is a significant swelling of the patient’s pad below the tapes of an I.V. catheter.  It usually occurs when one (typically the first tape on) or all of your tapes are too tight or have become tighter on the patient’s arm due to it’s position (curled under the body, etc) or localized edema due to other physiological issues.
• In an emergency situation do not concern yourself too greatly on how tight your tapes may be, you just need to get it in! Worry about “paddle foot” later.
• Ways to avoid “paddle foot” are careful placement of your catheter and tapes when initially getting an I.V. catheter in, assessment of your patient’s body condition (overweight, dehydrated, leg size, etc), and frequent careful monitoring of the patient’s catheter site and pad.

Please feel free to add your comments or suggestions on how you avoid “paddle foot” at your clinic.