Use of Long Boards for IV Stabilization

Intravenous, or IV, therapy is a common patient treatment in hospitals, clinics and outpatient care facilities. A long board or armboard is a useful piece of equipment used to stabilize IV sites in small children, infants or confused patients who might accidentally compromise the IV site. It's easy to use and can help prevent unnecessary needle sticks.

Prepare Supplies

• Ensure that patient has a properly working IV, or start one according to your facility's policies. While supplies may vary from one facility to another, you basically need the armboard (infant, pediatric or adult-size), Kerlix or gauze wrap and tape to secure it.

Prepare Patient

• Explain to the patient, if appropriate, or the patient's family that the armboard is used to prevent excessive movement and flexion of the IV site to help the IV last longer and avoid unnecessary needle sticks. It may help with small children to explain that it won't hurt them in any way, since even the simplest medical procedures can be very frightening to young children. The armboard serves as a gentle reminder to keep the IV site still. This is important because many IV medications can damage tissues if the IV catheter becomes kinked or damaged in the vein and fluid seeps into surrounding tissues.

Apply the Armboard

• With infants or combative patients, it may help to have a second person hold the armboard in place as you wrap it. The armboard usually has a curved or contoured side that goes toward the patient, with the flat surface away from the patient. Ensure that the armboard is properly positioned to isolate the IV site.

  For an IV in the hand or wrist, begin at the end farthest from IV site and wrap with Kerlix or other gauze wrap around the arm, working toward the IV site. Gauze wrap should completely cover the armboard to hold it in place. Avoid wrapping too tightly. Continue wrapping until the end is covered and IV site is secured under gauze. Apply tape to secure loose ends and hold the wrap in place. Be sure that the gauze can be pushed aside to allow visualization of the IV site as needed.

  For an IV in the AC (bend of the arm) area, position the armboard so that its center is near the IV site. This will limit the ability of the arm to bend and damage the IV catheter. Begin wrapping as above, starting at one end and working to the other. In the area near the IV, be sure it is possible to push the gauze wrap aside to visualize the IV site. Secure loose ends with tape as above, avoiding allowing the tape to stick to skin. Extra gauze wrap may be left at the bedside for reinforcing or changing as needed.

  Finally, chart the armboard application in the appropriate area of IV site charting in patient's chart. Remember to pass this information along in report. Monitor patient's capillary refill below the armboard and check that it is not too tight on a regular basis. Some facilities may require this to be checked and charted every two hours, as you would do with restraints.