Idea Exchange: A tip for placing transcutaneous stay sutures

I commonly place transcutaneous stay sutures in critically ill patients to secure nasoesophageal tubes, nasal oxygen tubes, or urinary catheters. I find that most patients tolerate tube placement after systemic administration of an opioid analgesic with or without a benzodiazepine for anxiolysis. But with the sedation, many patients do not tolerate transcutaneous passage of the swaged needle and suture. Most patients do, however, tolerate the passage of a 22-ga hypodermic needle through the same site. Once the hypodermic needle has been passed, any type of 3-0 suture material can be passed through the needle and secured once the needle is withdrawn.

Dr. Todd Duffy, DACVECC

Madison, Wis.