Volume 8, No. 4 • Winter 1993

Prevention Solves Epidural Disconnect Problem

Stephen F. Kennedy, M.D.

To the Editor

A letter to the editor in the Summer 1993 APSF Newsletter regarding the controversy about reconnecting a disconnected epidural catheter recommended that ‘the most prudent course of action to prevent catheter related infection is to select an epidural catheter hub/connection with the least likelihood of disconnect, to take all precautions to prevent disconnect and remove or replace any catheters that do become disconnected.’ In our busy practice, disconnected catheters became an everyday nuisance and a major inconvenience, taking away from our other more important clinical duties. All catheter and adapter assemblies can become disconnected. Some fit better than others, but often at a much greater per unit cost.

An inexpensive method for providing a secure catheter adapter connection is to fold a simple piece of 2-inch tape over on itself sandwiching a loop of the catheter and the adapter as noted below. The tape must cover the distal portion of the adapter leaving only the male end to connect to a syringe or luer-lock catheter. Since we instituted this taping method, we have not had any disconnections and thus no need to consider any sterilizing process and, even better, no time wasted attending to or replacing these catheters. It is difficult to justify purchasing an expensive adapter when a simple piece of tape will do the job.

Stephen F. Kennedy, M.D. Director, Pain Service Fairfax Hospital

Falls Church, VA