What is your practice of securing Umbilical Catheters (UACs or UVCs)?

In our unit, we prefer to centrally catheterize all extreme Preterms (<28wks) as soon as they amine from the delivery unit. However, we have seen delays in actually getting the catheters in place quickly enough to offset the in risk of hypoglycemia so, in addition, we prefer to quickly peripherally cannulate the veins first before the Main procedure to offset risk, of delays.

In our unit, we have moved away from 'Goal-Post' method of using tapes applied to abdominal wall to using 'Anchor-stitches' to the Umbilical stump skin rather than to the Wharton jelly of the stump itself. Therein lies the controversy of causing neonatal pain in a non-morphinised infant. However, a little pain now offsets the greater risk of blood loss and infection later associated with re-inserting the catheters in less than ideal circumstances.

We tend to keep these central catheters for 7 days approximately and replace them with percutaneous long lines' (catheters).

So what is the practice in your unit?

We follow S.T.A.B.L.E guidelines and use a Tegederm to loop the line right next to the skin, leaving the stump uncovered. We suture the line to the umbilical stump thus allowing the nurses to easily read where placement is. This work well and the tegederm does not need to be replaced.