Abstract:
A preemptive bandaging device is presented for the facilitation of intravenous catheter placement and anchoring. The bandage of the present invention includes a frame of bandage base material and a hingedly attached door of a thin bandaging film, a layer of carrier paper to serve as a deployer, and an optional bandage base flap or island for integrating the present invention with certain tube and catheter stabilization devices. The dressing is anchored to the skin so as to frame the I.V. site. The bandage features anchors for I.V. tubing and is placed so as to frame the I.V. procedure site. Once the catheter is placed, deploying the door covers and secures the tubes and the catheter with a thin film of clear bandaging material.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS  
       [0001]     This invention is a further simplification and specialization of the invention disclosed in this inventor&#39;s previous provisional application Ser. No. 60/499,118 filed Aug. 29, 2003 and it claims priority to this inventor&#39;s provisional patent 60/556,682, filed Mar. 29, 2004 and is a continuation of pending patent application Ser. No. 10/906,630, filed Feb. 28, 2005. The background of the invention remains the same and reference is made to the previous applications. 
     
    
     FEDERALLY SPONSORED RESEARCH  
       [0002]     NA  
       SEQUENCE LISTING OR PROGRAM  
       [0003]     NA  
       BACKGROUND OF THE INVENTION  
       [0004]     For a better understanding of the present invention, together with other and further objects thereof, reference is made to the following description, taken in conjunction with the accompanying drawings, wherein like numerals refer to like elements throughout the several views, and its scope will be pointed out in the appended claims.  
       FIELD OF THE INVENTION  
       [0005]     The present invention relates to dressings to dress and to facilitate stabilization of indwelling vascular catheters. More specifically, this invention relates to the facilitation of one-handed application of such dressings by providing a dressing and methods whereby the dressings can be placed on a procedure site prior to the performance of a medical procedure, the medical procedure can be performed, and the bandaging and catheter stabilizing procedures can be completed virtually simultaneous with the completion of the catheter placement.  
       DESCRIPTION OF RELATED ART  
       [0006]     Healthcare workers are at risk of serious infections if exposed to pathogens which are commonly present on needles and other sharp devices after such devices are used to break, cut, or puncture the skin of a patient. It is widely recognized that body fluids containing bloodborne pathogens are a serious vector of transmission of infectious diseases. The spread of bloodborne pathogens to clinical practitioners and others by contact with the body fluids of an infected patient is an inherent risk that is routinely taken when conducting procedures involving skin punctures which may expose the provider to blood and other body fluids. Further, certain procedures require that a provider infuse fluids into a patient that may be harmful to the provider. This could include, for example, when providers provide medications to which they themselves may be allergic. Vascular catheterization is one of the procedures that carries with it inherent risks of exposure to bloodborne pathogens. When a catheter is first placed, blood commonly escapes from the system, thereby contaminating the field. The provider is then tasked to secure the catheter, dispose of the cannula, dress the site, secure the I.V. line and avoid undue exposure to contaminated matter.  
         [0007]     As such, numerous protocols and medical devices have been developed in order to minimize risks. In particular, catheter anchors, I.V. medical line anchors and stabilizers, safe needle handling, needle disposal practices, needle covers, and needle retractors help to prevent inadvertent needle sticks with contaminated sharps. Some of the developments, such as needle retractors, have brought with them new problems. Some needle retractors, for example, retract with such velocity that the contents of the needle barrels, which may include infectious bio-matter as well as toxic pharmaceuticals, may be aerosolized and even splashed back towards the healthcare provider. Puncture site coverings and wound coverings protect others from contact with post-procedure fluids and exudates. Numerous types of absorbent and adhesive bandages are known in the art that can be applied to a puncture site or vaccination site on a patient. In general, these bandages include an absorbent material that covers the procedure site and an adhesive to keep the absorbent material and procedure site contents in place and to isolated. The bandages protect the patient from microbial contamination of the broken skin while healing and also protect practitioners from the body fluids that can shoot, spray, or seep from the wounds. Although traditional bandages perform these functions, to a certain extent, they do not offer the advantages that accompany rapid deployment nor do they offer needlestick injury protection. Further, in the past, it has not been possible to complete the anchoring of a catheter and the covering a procedure site simultaneously, because the technology simply did not address that possibility.  
         [0008]     Certain devices exist in the market now for rapid stabilization of I.V. lines and catheters, but they are intended to be placed on the patient after the catheter has been placed in the vein, opening up the operation to the possibility of losing the vein while trying to stabilize the catheter and tubing.  
       SUMMARY OF THE INVENTION  
       [0009]     This invention relates to a preemptive patch for dressing and stabilizing intravenous lines and catheters. In both veterinary and human medicine, after placing an I.V. or arterial line or a catheter or a needle into the lumen of a blood vessel, stabilization of the catheter and the I.V. set and safe disposal of contaminated waste becomes an immediate consideration. Taping down of the tubes and stabilization of the catheter can be a clumsy activity, often resulting in the loosening or accidental removal of the catheter or loss of proper catheter placement or extravasation of fluids.  
         [0010]     Additionally, in veterinary medicine, the task of stabilizing an indwelling vascular catheter, after it has been placed in a vascular lumen, can be a daunting task requiring securing the catheter to tape and then securing the tape to the animal. During catheterization and once a catheter has been placed, there is no assurance that the patient will not be jumping or running away or biting at it or biting the provider. Rapidly and securely stabilizing the catheter is of primary importance and the temporal window of opportunity to stabilize a catheter may be small.  
         [0011]     Additionally, although the invention is designed to function with currently available intravenous catheters and even with luer hub needles, the disclosure also includes embodiments that further include modified catheter hubs and modified catheter adapters that work better with the dressing of the present invention. These modified catheters have what are called grabber extensions on them. Such extensions are typically composed of the same material as the catheter hubs. The extensions are molded into the catheter hubs and parallel the vessel when the device is placed in its lumen. Embodiments are foreseen wherein the extension is flexible or even hinged, such that it could be positioned out of the way or the provider while the device is being placed in the lumen, and then it can be moved into close proximity with the skin after the catheter has been placed.  
         [0012]     The hub of a catheter is rather small and the typical hub of a needle is even smaller. As such, a catheter must be placed and positioned such that the hub is inside the boundary of the film of the deployment door. Hence, extending the  
         [0013]     An embodiment is also disclosed wherein the grabber extension is a component of a catheter adapter. In an embodiment of this type, the catheter can be placed in the vessel and then, after the placement, plugging the adapter into the female catheter hubs positions the grabber extension parallel to the catheter. The effect of placing and positioning a grabber extension as described is that the dressing film will have more material to grab when the dressing is deployed in addition to the hub.  
         [0014]     This application discloses a device designed to overcome the problems associated with securing and dressing an I.V. catheter placement. This application presents a device that is placed on the patient prior to placement of an I.V. catheter. It presents several variations of the device with varying levels of convenience and utility. It addresses the problems, in part, by changing the procedure&#39;s bandaging syntax and method, so that the bandaging and stabilization of the catheter and potentially the I.V. lines as well, occur partially prior to the catheterization of the blood vessel and completely within moments after. Although I.V. traditionally refers to intravenous, it will be used in this document to refer to any invasive medical device placement including, but not limited to, subcutaneous, intravenous and intra-arterial placements.  
         [0015]     When affixed to skin prior to an I.V. procedure, such a device would decrease the time that would be needed to stabilize the catheter, once the catheter had been placed. It could pre-stabilize the I.V. line using one or more of several means and methods. If fact, it would increase safety and decrease the overall catheterization time, from start to finish, because the bandaging procedure is very rapid and further incorporates the catheter stabilization and the medical tube stabilization, which are two additional procedures.  
         [0016]     The device can be supplied flat, in a cocked state using a retention extension or it can be supplied flat in an un-cocked stated, using the deployer dual retention leg configuration of  FIG. 1 . Such a configuration can be cocked after it is placed on the patient by opening the door and folding the legs under. The cocking procedure has been disclosed in this inventor&#39;s previous utility application, 10/906630.  
         [0017]     At least one embodiment of the present invention has an I.V. extension line affixed to the patch itself. The device can be provided with this extension already attached or the extension can be included, separate from the device, as an accessory to the dressing. As part of the dressing, rather than connected to the I.V. fluid source, this extension facilitates changing the I.V. line without approaching the catheter. The medical supply line could be disconnected from the extension and the extension could be capped off, as needed, to provide patient mobility, such as for a shower. Because the directional orientation of the extension tube will determine or at least suggest the handedness of the provider, it is preferable that the provider place the tube for his or her comfort. Typically, a right-handed provider will place the tube and the door to the left and a left handed provider will place the tube and the door to the right. With the dressing oriented as just described, the hand that places the catheter into the vessel will be on the unobstructed side of the dressing.  
         [0018]     Another accessory to the preemptive I.V. stabilization dressing is a hub anchor stabilizer pad or hub anchor stabilizer island, herein, the island, where a hub anchor is a device intended to secure the hub of an I.V. line or that of a catheter. Numerous devices have been described in the literature for stabilizing tubes and tubing hubs after the catheter has been inserted. These devices or catheter anchors, must be placed after the catheter is placed to make sure that they are in the correct location. An optional member of the present invention is an island that serves as a pad for such an anchor. An island, composed of a section of flexible bandage base with a small tongue of bandage base, could be included with the dressing. The bandage base material, with a protective carrier paper layer on the bottom, could be adhered to the bottom cross-member of the frame by the tongue. Then a catheter anchoring device, such as disclosed by 6,837,875 Bierman, Jan. 4, 2005, could be anchored to the dressing on the island, prior to placing the catheter. While the Bierman &#39;875 device was developed for use after the catheter was already in place, anchoring a flexible bandage base material to a cross-member of the present invention would provide a movable catheter anchor base, such that, after placing the preemptive dressing, a catheter anchor could be placed on the island and could still be moved so the its receptacle could be easily positioned to coincide with the tube hub. In particular, that of Bierman &#39;875 being somewhat positionally forgiving would be a logical choice for incorporation into, or for use with a device of this nature. Having been somewhat stabilized prior to the insertion of the catheter, fumbling, to place the catheter anchor while protecting the catheter placement, is minimized. The catheter anchor can be anchored to the island prior to the placement of the catheter in the vessel. Because the island can be fitted with an optional tongue, a catheter anchor can be affixed to it and the island can be anchored to the bandage base or to the skin by adhesive on the bottom surface of the tongue, yet, it can still be easily moved small distances, sufficient to place a medical tube into the anchor, until the removal of the carrier paper on the bottom of the body of the island, at which time it is anchored to the skin and stabilized. Many catheter anchoring systems and devices are currently available in the marketplace and others, not yet available, are covered by patents and pending patents. It is obvious to any person skilled in the art that substitution of one catheter anchoring device for another would still provide a device within the scope of the invention. Obvious changes in the relative sizes and shapes of the catheter islands and changes in the catheter anchoring device with which it might be paired, could produce a myriad of similar devices that all would fall within the scope of the invention.  
         [0019]     Numerous I.V. medical tube sets and I.V. set extension devices exist in the medical world. These devices are fitted with accessories chosen from a myriad of adapters, including, but not limited to, stopcocks, y-sites, caps, bifurcations, rate controllers, and slide clamps. The novelty of the present invention is further enhanced because elements are herein disclosed for affixing such I.V. sets and I.V. extension devices to the invention. In this way, the I.V. tubing can be anchored or stabilized, prior to starting the catheterization. Configurations are disclosed herein such that, although anchored, the male end of the tube that inserts into the female hub receiver of the catheter would remain mobile, within a limited range and a I.V. tube anchor can be placed, preemptively, on an island, where the anchor could secure the tube male hub, prior to inserting the catheter in the lumen of a blood vessel. In this way, when the catheter is placed in the vessel and it is time to connect the I.V. line to the catheter, the I.V. catheter adapter is in close proximity to the catheter hub and only a small movement is needed to place it and complete the connection. Embodiments of the invention are foreseen wherein the present invention might be combined with any or all of the accessories named in this paragraph.  
         [0020]     When using any embodiment that includes an integrated or a separate extension tube section, tube stabilization could be incorporated into the tube extension design. The tube stabilizer could be as simple as a binary contact adhesive on the tube that is non-adhesive until placed into contact with its counterpart on the bandage base, or an adhesive patch surface that is exposed when a carrier paper on the frame cross-member is removed to allow the tube or the adhesive of the two adhesive coated members to come into contact with one another. Some binary adhesives do not require being covered by a carrier paper protector. A more aggressive adhesive could be used, on the cross-member only, to grab an uncoated tube when the tube is pressed against the cross-member.  
         [0021]     Inclusion of a tube extension with the dressing opens many avenues of tube anchoring. For example, a sliding tube anchor could be included with the device such that; a.) the tube anchor could be a molded plastic ring with a flat base and the tubing could be threaded through such a ring before the molded hubs were placed on the ends of the tube so that the anchor would easily slide on the tube and could be placed on the island or on the cross-member and then, once the catheter has been inserted in the lumen of the vessel, the tube would slide through the ring so its male connector hub could enter the female catheter hub and close the fluid circuit.  
         [0022]     Tube anchor options include bi-digital ring of plastic, like a thumb and forefinger coming together or a child&#39;s adjustable toy ring or a plastic clamp, similar to the bi-digital ring, each of which could exert variable pressure against the tube, such that the tube could be moved through the bi-digital ring as needed and the ring would grasp the tube with sufficient force to anchor the ring to the tube wherever the tube was released  FIG. 12 . This way, the tube could be preemptively anchored to the dressing, yet would still be positionable. A tube anchor, such as that of  FIG. 12   a  with tunnel to trap the tube, so that the tube was limited to moving in only 2 dimensions would also work. Both of these anchors are disclosed in greater detail below. An anchor similar to the embodiment of  FIG. 12   a  is foreseen with a tunnel with sufficient diameter to pass a luer connector, therefore obviating the need to place the tube into the anchor until just before the procedure.  
         [0023]     Additionally, a device of this nature is in alignment with the intent of the current needlestick injury prevention guidelines, because it minimizes the likelihood that the catheter would slip from the vein, exposing healthcare providers or third parties to the inevitable spillage of body fluids and it permits the provider to immediately focus on the safe disposal of the cannula.  
         [0024]     This invention has unique properties which are extensions and variations and specializations of those disclosed in provisional application Ser. No. 60/499,118, filed Aug. 29, 2003 and shows a method of simplification of the invention of Ser. No. 60/499,188. This device shares the property of being used preemptively, that is, before the skin is penetrated and may use a window through which to access the vein. It has an adhesively hinged door which is closed to complete the bandaging process immediately after catheterization. This device is unique in that it may incorporate either an I.V. tube extension or an adhesive mount for the I.V. tube into its design and that it has a film, typically clear, which is attached to a door than can be closed over the catheter and tube end, to rapidly secure the intravenous infusion device(s) in place. The film may be opaque but in the preferred embodiment, the film is clear and is adhesively coated on the surface that covers and anchors the catheter. Disclosures prior to 60/499,188 did not speak to catheter nor to I.V. line stabilization.  
         [0025]     In it simplest form, embodied in  FIG. 13 , the dressing of the present invention may comprise nothing more than a deployment door made of a piece of tape affixed to a piece of carrier paper. Exposing one edge of the tape exposes a strip of adhesive on one edge of the tape. That strip can be adhered to skin or to a bandage base. Then the portion of the tape that is still affixed to carrier paper can be folded at the edge of the carrier paper that transverses the adhesive layer of the film. The fold, in essence, hingedly affixes the deployment door, which is the carrier paper and all film affixed to it, to the skin. The deployment door can be folded about the hinge and the portion or the carrier paper that is not affixed directly to film becomes a retention extension. When the dressing tries to unfold, the retention extension will contact the skin before the dressing unfold more than about 90 degrees, resulting in a dressing that is cocked on the skin. Various means of preventing the folded dressing from unfolding are presented in this application.  
         [0026]     Most of the embodiments described herein also comprise a bandage base layer in addition to the deployment door of the previous paragraph. The preferred embodiment of the present invention includes a deployment door and a bandage base, made of traditional bandaging materials, such as, but not limited to plastic, cloth, cotton, polyurethane, or foam, and adhesive coatings. The base may be a simple piece of foam or tape, coated with adhesive on one side, or it may further include an optional absorbent pad. Such a pad could be located many places on the tape, including part on/part off, depending upon the intended use of the device.  
         [0027]     This bandaging device may further comprise medical tubing. The bandage base has a top surface where an I.V. tube can be quickly anchored during the catheterization process. It may have an I.V. tube extension affixed to it, one end with a female receptacle for receiving the male hub end of an I.V. tube set and the other end with a male connector to fit directly into the catheter, typically a luer type connector. Typically, the end of the tube that is plugged into the catheter hangs loose until after the catheter is placed in the blood vessel. Then the tube&#39;s catheter adapter is plugged into the female hub of the catheter. Then a protective carrier paper cover on the adhesive anchor is removed so the end of the tube extension can be adhered to the adhesive on the top of the bandage base; and hence, the tube is rapidly stabilized.  
         [0028]     The device is adhesively affixed to skin prior to an injection or medical procedure. Once pre-placed, all components of the dressing remain clear of the operative field until it is needed. The section of the bandage that contacts the skin may have a portion removed to define an aperture or it may be designed in such a way that it can be placed close to the procedure site so as to infer the procedure&#39;s intended location from the positioning of specific components of the bandage. The less expansive embodiment, the embodiment with neither a frame nor an aperture, such as those embodiments disclosed herein shown in  FIGS. 5   a  and  11  and  11   a  are less expensive to manufacture.  
         [0029]     The present invention further includes methods of applying dressings, including the embodiments disclosed herein, to human or animal tissue, prior to the inception of an invasive medical procedure, such as an intravenous catheterization. The present invention includes means and methods of retaining said bandage in an un-deployed or cocked state and preventing it from entering the operative field prematurely.  
         [0030]     It is widely recognized that body fluids containing bloodborne pathogens are a dangerous and serious vector of transmission of infectious diseases. The spread of bloodborne pathogens to clinical practitioners and others by contact with the body fluids of an infected patient is an inherent risk that is routinely taken when conducting procedures involving skin punctures and releasing blood and other body fluids. Further, certain procedures require injection of infusion with materials that may in themselves be potentially infectious or dangerous to the provider. Some medical practitioners are, themselves, allergic or sensitive to certain of the medications or drugs that they provide to patients. Penicillin is a good example. Because this device rapidly anchors catheters and tubing, opportunities for the escape of body fluids from the invasive medical intervention site are minimized. Prevention of exposure of these practitioners to sharps-borne and blood-borne materials that may cause them harm is an important benefit of this invention.  
         [0031]     It would be advantageous to have a procedure site dressing available to clinicians that overcame the above-cited disadvantages. In particular, it would be desirable to have available a dressing that permitted the clinician to apply the dressing before performing an invasive procedure so that the contaminated sharps could be discarded without the clinician have to simultaneously bandage the site. Additionally, it would be advantageous to have a device that stabilized a catheter placement without requiring further handling or taping of the catheter or tubing.  
       DESCRIPTION OF The INVENTION  
       [0032]     The invention is essentially a device that stabilizes an intravenous line during and after the process of intravenous catheterization. Embodiments disclosed herein include tubes that extend the reach of standard I.V. tubes. The value of this is that the extension tube can be anchored to a piece of bandaging material which is adhered to the skin prior to the introduction of a catheter. An embodiment of the device, disclosed herein, has an aperture through the base of the patch that clearly defines the procedure site where the catheter will be introduced. In another embodiment, rather than an aperture, the portion of the bandage that actually frames the skin site is missing and the procedure site is inferred from the position of the hinge of the preemptive bandage.  
         [0033]     To use the device with an I.V. line extension: 1. The device is placed on the skin with the I.V. site visible through the aperture. 2. The I.V. line is attached or plugged into to the extension. 3. The extension is filled with fluid from the drip bottle, that is, the air is purged and flow is halted. 4. The catheter is placed in the vein and then the male plug of the extension is plugged into the catheter. Until the extension is plugged into the catheter, the male catheter end of the extension remains free or partially controlled by a hub anchor, to make it easy to control the tube and to plug it into the catheter. 5. Positioned between the bandage base and the catheter, there may be a piece of adhesive, covered by release paper. When the release paper is removed, the adhesive is exposed and simply pressing the extension tube against the adhesive anchors it. Depending on the technique being used, the extension can be plugged into the catheter before or after the catheter is placed in the vein. Optionally, the extension tube can be pre-loaded with certain fluids or medications.  
         [0034]     The basic invention is a hinged or cockable hinged door of dressing material. The door has two or three layers. One or two of the layers are release paper and the other is an adhesive coated bandaging material, such as polyurethane, typically clear. When the door is cocked, pulling the tabs or retention extension on the release paper rotates the adhesive into contact with the catheter and the tube extension and instantly anchors them both in place. Techniques for using the invention will vary by provider and the needs dictated by the procedure for which it is being used. Sometimes just the catheter will be secured by the door and sometimes both the catheter and the I.V. tube will be secured by the film.  
         [0035]     Alternatively, if a layer of release material is also attached to the non-adhesive side or back of the polyurethane, the inner release paper, that affixed to the adhesive, is be removed first to expose the full layer of adhesive. Then the door can be rotated to bring the adhesive flat against the tube and the base frame and the skin, all at once. Pressing on the non-adhesive surface of the door to push the adhesive of the film layer against the catheter and tube will anchor the catheter and tube and door in place. Finally, the top piece of release paper can be removed to expose the clear polyurethane. This then permits the catheter and tube and skin and vein to become viewable through the clear bandage window.  
         [0036]     A variation of this device is designed especially for use in veterinary and pediatric medicine. In this embodiment, the base, beyond the aperture which exposes the vein, is much wider. In fact, it is wide enough that the adhesive can wrap all the way around a limb until the two ends meet. This addresses the problems that occur when one tries to tape an I.V. tube and catheter to the leg of an animal or a small person. The actual size of this device will vary greatly, depending upon the size of the animal that it will be used on. It could range from a total size that would be small enough for a kitten to one large enough for a horse or even an elephant.  
         [0037]     Some embodiments of the invention do not have the I.V. tube extension tubes included. In these embodiments, the location where the I.V. tube is to be placed, where the extension tube was on the previous embodiment, may have an adhesive strip on it. The adhesive is covered and protected by a protective piece of release paper. When the device is used, it is first placed over the vein, and then the I.V. tube is set up. The release paper is removed from the adhesive strip and the adhesive is exposed. Then the tube is anchored to the adhesive strip, the catheter is placed in the vein and linked to the I.V. tube. Then removing the protective paper exposes the adhesive just below the catheter. Then the tube and the catheter are anchored to the base. The deployer is used to deploy the dressing, to close the door as with the others embodiments.  
         [0038]     By providing a bandage that is placed over or near the procedure site prior to the invasive part of the procedure, the bandage itself becomes an integral part of the catheter placement procedure and can be used to complete the bandaging process within moments of, or virtually synchronous with, the completion of the procedure. This improved syntax frees the provider to dispose of the contaminated waste materials immediately, rather than after to maintain possession of contaminated materials with one hand while simultaneously performing a difficult bandaging procedure on the site with the other hand. This dressing rapidly, firmly, and safely stabilizes the I.V. tubes and catheters.  
         [0039]     It has now been discovered that certain methods of folding, taping, placing, and the applying the bandages disclosed in this application will greatly reduce the time it takes to complete the bandaging of a procedure site after the invasive part of the procedure has been performed. Additionally, because the bandage is applied before the procedure has been performed, not after performing a puncture, when using this invention, healthcare providers need not choose between disposing of a contaminated sharp, thus protecting themselves, and bandaging the site while maintaining possession of the contaminated sharp, thus protecting their patient.  
         [0040]     The invention is a dressing with a bandage base frame and a door, also called a deployment door, typically of a thin, transparent, adhesively coated bandaging membrane, such as a polyurethane tape or film weakly adhered to a carrier paper layer. The door is hingedly affixed to the bandage base by an adhesively coated edge of the film. The edge that affixes the film to the bandage base is called the anchor-flap. Except for the small amount to adhesive film that affixes the door to the frame, the adhesive surface of the door is up, and the door&#39;s adhesive surface is covered with release paper over its entire adhesive surface. The bandaging film used is any one of the many bandaging films available in sheet and roll form, wherein a release paper layer separates the contiguous sheets or layers of film and prevents them from adhering to one another. The film is hingedly affixed to the frame of the bandage base as a component of a deployment door. The film can be many sizes. It may be smaller than a strip of bandaging tape or as wide or wider than the bandage base of the dressing. Films of this type are supplied by manufacturers such as Avery Label and 3M and the film is weakly adhered, as delivered, to a carrier paper covering. The film, with its carrier paper layer, which will function as a deployer, together, comprise the deployment door. To affix the deployment door to the bandage base, some carrier paper is separated from a strip of film at the long edge of the door. The width of the strip must be sufficient to form the base of a hinge. Typically, the length of the door is about the same as that of the frame, although it can be smaller or larger than the bandage base.  
         [0041]     For a right handed embodiment, the full carrier paper remains intact and the film that has been separated from the paper film is folded about 180 degrees along its length and the adhesive of the strip is adhered directly to the frame, such that the door is open to the left and the door is hingedly adhered to the frame by the now folded under and bent into a hinge, strip of bandage base film. The carrier paper is a deployer. The separated portion of the carrier paper extends beyond the hinge and serves as a retention extension to prevent the door from entering, obstructing, or obscuring the procedure&#39;s operative field, both physically and visually. The retention extension also acts as a pull-tab that will be used to deploy the device.  
         [0042]     An embodiment of said dressing is foreseen with a plurality of apertures whereby said apertures are labeled or numbered and are placed on a patient for the purpose of allergy testing. Said embodiment is affixed to skin over an area of the body where a series of sensitivity tests are to be performed. A separate antigen could be injected into or dropped onto the skin in each of the apertures and then, when the dressing is deployed, all of the sensitivity testing sites are simultaneously covered with the transparent film. Such an embodiment could have the adhesive of said film over the entire adhesive coated side of the film or it could have windows devoid of adhesive over each of the apertures or, it could have only a frame or adhesive around the outside of the film&#39;s adhesive surface to seal the sites, yet not affect the optical quality of the film and not expose said patient to an adhesive that might change the results of said sensitivity testing.  
         [0043]     The embodiments intended for veterinary use vary from their human counterparts primarily by size and shape. Adhering a dressing to human skin is a relatively straight forward process, whereas, indeterminate quantities, qualities, and varieties of hair often make adhering a dressing directly to animal skin nearly impossible. Shaving the patient may be the only way to address the situation. The dressing of the present invention addresses this problem by being available in many sizes, suitable for wrapping all the way around a limb that has been chosen as a catheter insertion site. While the dressing would adhere best to a fully shaved limb, that is not always practical. The size of dressing chosen is intended to be adequate to wrap around the limb and adhere to itself. The size of the window in the frame of a veterinary dressing of the present invention will tend to be smaller, relative to the side of the entire dressing. The size of the door will be smaller than the human counterpart, relative to the size of the bandage, but will be the similar, relative to the size of the procedure window.  
         [0044]     The embodiments provided herein as examples are for illustrative purposes and are non-limiting. An embodiment is foreseen wherein the bandaging film is far smaller than the bandage base and when the device is deployed, only a strip or a plurality of strips crosses the operative field, such that the tube and the catheter are bound separately or only the tube or only the catheter is bound by the film of the door.  
       NOVELTY OF THE INVENTION  
       [0045]     The present invention is a preemptive dressing for stabilization of I.V. catheters. In contrast to all other known methods of catheter stabilization, the device is placed over or near the catheterization site prior to placing the catheter into the lumen of a blood vessel.  
         [0046]     Prior art that shows devices meant to hold catheters and/or I.V. tubes in place speak to devices that are intended to be placed on the skin after the catheter has been placed. This is inevitably a clumsy operation because one must maintain the placement of the catheter or needle and manage the I.V. tube and connecting hubs, while simultaneously anchoring the devices with tapes of other devices that are to anchor them.  
         [0047]     In addition to catheter stabilization, the device also can preemptively anchor I.V. tubes. Previously existing device are designed to anchor only one or the other, not to anchor and dress both. The dressing of the present invention is designed so that an I.V. tube or an I.V. tube extension can be anchored to the body of the device before the puncture is made. With the tube pre-anchored, only the catheter and the male catheter adapter end of the I.V. tube need to be stabilized after the catheter is placed.  
         [0048]     In prior art, catheters are often stabilized by wrapping a piece of tape around the hub. Handling tape with gloves on is a delicate and often disappointing endeavor. The invention eliminates tape handling for catheter securement. The initial placement of the dressing coincides with anchoring of the tubing and precedes the placement of the catheter. Placement of the catheter is followed, within fractions of a second, almost immediately, by stable anchoring of the catheter without having to fuss with tapes or hub anchors. When the film door is closed over the catheterization site, the bandaging film of the door adheres to the catheter and to the skin or to the bandage base, which is adhered to the skin.  
         [0049]     Simply pulling the deployer across the catheterization site, exposes the adhesive of the bandaging film. Closing the door completes the process of stabilizing the I.V. catheter and I.V. tubes. In an embodiment with a three-layer deployer, removing the top deployer of the cocked dressing exposes the adhesive layer of the bandaging film. Then, rotating the door to bring the film into contact with the catheter, instantly stabilizes the catheter, and peeling off the stiffening layer deployer completes the procedure.  
         [0050]     In its simplest embodiments, the dressing is a deployment door, which is a layer of carrier paper, called a deployer, affixed to a layer of bandaging film as seen in  FIG. 13 . Although thin, transparent, medical films are the material of choice for the disclosed embodiments, those skilled in the art would acknowledge that any bandage base material including plastic, cloths, polyurethanes, and even metallic films could be substituted and still be well within the scope of the invention. The film is affixed to the deployer such that, when the deployer is pulled across the field of the procedure, the film peels off, adhesive side towards the procedure, where it adheres to the catheter and anchors the catheter in place, simultaneously stabilizing, dressing, and sealing the procedure site.  
         [0051]     In the present invention, a deployment door or a dressing comprising a deployment door is placed on the patient before a catheter is placed in the vessel. Such a deployment door may be anchored to a bandage base, or directly to skin, at many locations near the proposed procedure site and not diverge in any way from the scope of the invention. Such a pre-placement of a preemptive device for the securement of an indwelling catheter is previously unknown.  
         [0052]     Additionally, existing catheters are typically like an iceberg in that most of the catheter is unseen once the catheter is placed in a blood vessel. As such, the small portion of the placed catheter that resides outside of the skin is all that the provider has to anchor to tapes or other catheter securement devices to prevent the catheter from moving. A catheter hub grabber extension that can extend from the catheter hub or from a catheter hub adapter is disclosed in this application. This grabber extension that extends the portion of the catheter hub that is external to the skin and makes grabbing and anchoring the catheter an easier procedure because the grabber extension can be easily affixed to the door of the dressing or to a adhesive film to stabilize the indwelling catheter. Such an extension is not limited to I.V. catheters and can also be added to other catheters such as a Foley catheter.  
                                         Definition List 1            Term   Definition               Absorbent pad   A piece of absorbent material, such as, but not limited to, cotton           or a synthetic absorbent, such as a thin sheet of hydrophilic           absorbent polyurethane foam.       Bandage base   Any flat tape material used in the medical industry to make       180   adhesive bandages. The bandage base material is coated on           one side with an adhesive that has the necessary adhesive           characteristics to adhere the bandage base to skin.       Carrier paper   Any flat material used in the medical industry wherein the       or Release   outermost layer of at least one outer surface is comprised of a       paper 300   substance that will resist bonding, other than weakly, to           adhesives, and will protect the integrity of the adhesives.           Carrier paper may be coated paper, coated polyurethane, coated           polyethylene, coated polyester, or any flat material such that at           least one outer surface of the material will resist bonding to adhesives.       Catheter 210   Any medical device placed into the lumen of a blood vessel,           generally for the purpose of infusing a liquid into the vessel           through a concentric device lumen.       Cocked   The state of being locked in a predetermined position, yet           having the potential to move into another position when the           element or urge that is preventing it from moving towards its           potential is removed.       cocked   A dressing that has been distorted from its flat shape into a       dressing   particular stable shape or configuration in which it remains until           and unless acted upon by an urge means. Typically, a cocked           dressing is one that has been folded about a hinge and has been           locked in the folded configuration by at least one element of the           dressing adhering to or being unable to move past skin or           another element of the dressing.       Contiguous   Abutting: having a common boundary or edge; touching.       To deploy   To purposefully unfold the cocked dressing and bring it to rest           in a predetermined location.       Deployer 380   A device or a member of a bandage that can be used to move a           bandage from one positional configuration to another. Typically,           a deployer protects the adhesive surface of a flip-door, allowing           the flip-door to be handled by a provider. Some element of a           deployer can be grasped and pulled to purposefully unfold a           cocked bandage and bring it to rest in a predetermined location.       Deployment   A flip-door and a deployer adhered together. Both parts move       door 190 195   as one until the deployer is removed from the flip-door.       Film 500   Any thin flat material that could be used in the construction of           a medical dressing.       Flip-door 550   A flip-door is the entire dressing, that is bandage base or           bandage base and absorbent pad, except for the anchor-flap.           That is, on the bandaging element that comprises a hinge, the           anchor-flap ends at the hinge and the remainder of that element           is the flip-door, because, that is the portion of the dressing           that flips when it is cocked and flips when it is deployed.       Grabber   A protuberance on a catheter hub or on a catheter adapter hub       extension 220,   that extends the length of the portion of catheter material, of a       225   placed catheter, that is external to the skin. Such a grabber           extension typically parallels the subcutaneous portion of the           catheter and is easily grabbed by an adhesively coated           bandaging film to secure the catheter to skin or to a dressing or           both.       Hinge 160   The line in the bandage base or a line in the bandaging film           base, where the dressing is folded when it is cocked. When an           absorbent pad is present, as in the preferred embodiment, the           hinge is generally a line at the intersection of the anchor-flap           and the absorbent pad, although, atypically, a dressing might           have its hinge located under the absorbent pad.       I.V. catheter   Any connector on the end of an I.V. line that has the purpose       adapter   connecting the line to an intravenous catheter. These are           generally male luer connectors, although proprietary adapters           could fall within the definition.       Invasive   A bandage base, generally with an absorbent pad somewhat       medical   centrally located on the adhesive surface of the bandage base,       procedure site   the proposed purpose of which is to adhere to skin to protect       dressing   wounds created during the course of a medical procedure, such           as an injection, from pathogenic invasion, and to prevent body           fluids from migrating beyond the immediate wound site.       Catheter   The most likely sharp to be used in conjunction with the present           invention. Typically, a catheter is a medical device with a needle           inside sheath, the two having concentric lumens. When the word           catheter is used in this application, any medical device that           might be used in the procedure, other than specifically a           catheter, is explicitly implied. As such, any catheterization           procedure or procedure cited in this application may also be           read to include any invasive medical procedure, including, but           not limited to, an injection, a surgery, or a debridement, that           might also be performed at the site.       Provider   A person who administers the invasive medical procedure that           will be bandaged using the dressing of the present invention.       Preemptive   A bandage that is used when a wound is foreseen on presently       bandage   unbroken skin. Typically the wound is the result of a skin           puncture, such as from an injection or a catheterization           procedure, or from an incision, as would occur during a surgical           procedure. Prior to the invasive part of such a procedure, such           a bandage is placed on, over, or near the potential wound so           that the dressing can cover the wound as rapidly, often almost           immediately, after the wound occurs.       Procedure   Any medical procedure, including any invasive medical           procedure.       Retention   A section or piece of a deployer which is generally a sufficient       extension 320   amount of carrier paper material, in addition to the portion of       321   the deployer that is adhered to a flip-door of a dressing, to           extend the physical boundary of the deployer beyond the hinge           of the flip-door.       retention leg   A type of retention extension. Any retention extension that is       360 362   smaller than the full width of the deployer is a retention leg.       Retainer   A means whereby an object is retained. In this application, the           disclosed tube anchors are retainers.       Slug 350   A section of carrier paper that covers the anchor-flap of a           dressing, which, upon removal, permits the dressing to be           affixed to skin, in a configuration such that the dressing can be           subsequently cocked.                  
 
       DRAWING REFERENCE NUMERALS LIST  
       [0000]    
       
           110  Adhesive surface of bandage base  
           113  Aperture  
           114  Flap  1   
           115  Flap  2   
           117  Adhesive clasp  
           118  Non-adhesively coated back side of bandage base or back of bandage base  
           180  Bandage base  
           190  2-layer deployment door  
           195  3-layer deployment door  
           200  I.V. line or medical tubing extension  
           202  I.V. line cross section  
           205  I.V. line or I.V. line extensions medical tubing receiver hub or female luer hub.  
           210  Catheter  
           212  Catheter hub extension  
           215  Catheter female hub  
           220  Male end of catheter adapter  
           225  Catheter adapter extension  
           230  Island  
           235  Island tongue  
           240  I.V. line or medical tube anchor  
           241  IV line or medical tubing anchor base or body  
           242  Medical tubing expansion retention anchor clamp  
           243  Medical tubing anchor clamp handle  
           245  Tube anchor tunnel  
           247  Flexible fingers  
           250  Absorbent pad  
           300  Carrier paper or Release paper  
           302  Carrier paper  2  or stiffening layer  
           304  Tube anchor carrier paper layer  
           306  Tube anchor carrier paper layer pull-tab  
           320  Retention extension  
           321  stiffening layer retention extension  
           325  Deployer body  
           360  Left leg or left retention leg  
           362  Right leg or right retention leg  
           380  Deployer  
           400  Skin surface  
           410  Blood vessel  
           450  extremity or limb  
           500  Film layer  
           510  film anchor-flap  
           520  Adhesive surface of film  
           530  Back, non-adhesively coated, side of film layer  
           550  flip-door  
           560  Hinge  
           700  The invention or the dressing or the invasive medical procedure site dressing, including at least a film layer, and a deployer.  
           800  Adhesive coated section  
           802  Adhesive coated section  2 . 
       
     
     
    
     BRIEF EXPLANATION OF THE FIGURES  
       [0101]      FIG. 1  is an oblique view of the present invention.  
         [0102]      FIG. 2 . is the invention of  FIG. 1 , with the carrier paper layer removed.  
         [0103]      FIG. 3  is an oblique view of the present invention.  
         [0104]      FIG. 4  shows the invention wrapped around a limb and affixed to said limb.  
         [0105]      FIG. 5  is a top view of the invention with a medical tube extension, an island, and a medical tube anchor.  
         [0106]      FIG. 5   a  is exactly like  FIG. 5 , except that one of the bandage base flaps is very short.  
         [0107]      FIG. 6  is the same as  FIG. 4 , except a medical tube extension has been added.  
         [0108]      FIG. 7  is the invention with a medical tube threaded through a medical tube anchor view from the film layer side.  
         [0109]      FIG. 8  the embodiment of  FIG. 7 , viewed from the deployer side.  
         [0110]      FIG. 9  is a bottom view of the dressing with 2 absorbent pads affixed to the bottom of the bandage base.  
         [0111]      FIG. 9   a  is a view of the dressing of  FIG. 9 , from the top side.  
         [0112]      FIG. 10  is a close-up of the invention disclosing an alternate 3-layer deployer door.  
         [0113]      FIG. 10   a  is the embodiment of  FIG. 10 , with the top deployer removed.  
         [0114]      FIG. 11  is an oblique exploded view of a two-element embodiment of the invention.  
         [0115]      FIG. 11   a  is an assembled view of the embodiment of  FIG. 11 .  
         [0116]      FIG. 12  is an oblique view of a re-positionable bi-digital tube anchor.  
         [0117]      FIG. 12   a  is a frontal view of a tunnel version tube anchor.  
         [0118]      FIG. 12   b  is an oblique view of a tube anchor with flanges anchoring an I.V. tube.  
         [0119]      FIG. 12   c  is the tube anchor of  FIG. 12   b  without the I.V. tube.  
         [0120]      FIG. 13  is an oblique view of a 2-piece embodiment of the invention.  
         [0121]      FIG. 14  is an oblique view of an I.V. catheter with a grabber extension.  
         [0122]      FIG. 15  is an oblique view of an I.V. catheter adapter with a grabber extension from the male end.  
         [0123]      FIG. 15   a  is an oblique view of the I.V. catheter adapter of  FIG. 15  from the female end.  
         [0124]      FIG. 15   b  is the embodiment of  FIG. 5 , with the grabber extension I.V. catheter adapter with extension mounted on the I.V. tube extension. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0125]     Before discussing the structure of the invention in detail, note that the layers of materials used in the structure are quite thin. In the various figures, the thicknesses are sometimes exaggerated for clarity of illustration. In particular, layers of adhesive are usually not shown, as the adhesive is generally coated directly onto the components and is not technically a separate part. All adhesive coated parts are clearly identified and the sides and portions of the components that are adhesive coated are clearly defined. Recognize, also, that when exaggerations occur, they also exaggerate the curvatures that occur in the drawings at the overlapping intersections of various layers.  
         [0126]     The present invention, as seen in  FIG. 1 . is a preemptive dressing  700  for use with invasive medical procedures, typically for use with procedures wherein a catheter or a needle is placed in the lumen of a blood vessel. This device shown  700  is configured to be placed on the skin of a patient, prior to introducing a medical device into the lumen of said vessel. The dressing  700  is placed on skin so that the blood vessel to be catheterized is visible and accessible via an aperture  113  in a bandage base  180 . A deployment door  190  is shown, which is the aggregate of a deployer  380  and a bandaging film layer  500 . The deployer has two sections, the deployer body  325  and a retention extension  320  which is further separated into two separate extension legs  360   362 .  
         [0127]     The invention  700  is shown in  FIG. 2  with the deployer  380   FIG. 1  absent. In this view, it can be seen that the film or bandaging film material  500  is hingedly attached to non-adhesively coated side  118  of bandage base  180  by hinge  560  which is a flap the adhesive layer  520  of film material  500  folded under and affixed to said bandage base  180 . The hinge  560  in film  500  is approximately parallel to the transverse edges of aperture  113  in bandage base  180 . The aperture  113  herein is rectangular, but nothing in this disclosure is intended to limit the size, shape, or location of said aperture  113 .  FIG. 3  is a similar embodiment to the embodiment of  FIG. 1 . It differs in that there is only one retention extension  320 , which functions as a pull-tab of deployer  380  and bandage base  180  flaps  114   115 , are long. The long flaps  114   115  are so the bandage base  180  of the device can be wrapped around a limb and adhered to itself, to make it more secure on the patient.  
         [0128]     In veterinary medicine, catheter securement has challenges beyond those of human medicine. Animals typically have an abundance of hair or fur and often must be restrained during the catheterization procedure. Therefore, a method of secure and rapid catheter stabilization would be valuable. The embodiment of  FIG. 4  is the same as that of  FIG. 3 .  FIG. 4  shows the two flaps  114   115  of bandage base  180  wrapped around a limb, and adhered together by an adhesive clasp  117 . The skin  400  of a limb  450 , and a sub-cutaneous blood vessel  410  are visible through aperture  113 .  
         [0129]      FIG. 5  is an embodiment of the invention that includes two separate methods of stabilizing the medical line. It also shows a medical line extension  200  that can be affixed to the dressing by adhesive surface  802  to preemptively stabilize the line and further facilitate the catheterization process. When said extension  200  is used, the medical line coming from a fluid supply can be changed at the I.V. tube extension hub receiver  205  rather than at the procedure site. Using this format, the provider is further away from the catheter  210  and the I.V. tube male catheter adapter  220 , therefore there is less chance of exposure to bloodborne pathogens when changing I.V. lines. This embodiment also shows an island  230  and an island tongue  235 , composed of bandage base material and island  230  and island tongue  235  have a carrier paper layer on the bottom. The adhesive surface of tongue  235  can be exposed by removing carrier paper, not shown, from the bottom. Then tongue  235  can be adhered to bandage base  180 . An I.V. line anchor  240  is adhered to island  230 . The I.V. line  200  can be retained by retainers such as an I.V. line anchors of any common commercially available type, such as those manufactured by Venetec International Inc, San Diego, Calif. or by the I.V. line anchors disclosed in this application. Tongue  235  allows the I.V. line extension  200  and the male hub  220  on the I.V. line extension  200  to be secured, yet still to be moved small distances, such as far enough for hub adapter  205  to be engaged to and disengaged from female catheter hub  215 .  
         [0130]      FIG. 5   a  is exactly like  FIG. 5 , except that bandage base flap  115  is shortened. This embodiment shows that a large bandage base flap  115  with or without aperture  113  is not required. This embodiment is simpler and less expensive to manufacture than any of the others disclosed here in the previous drawings. The embodiment of  FIGS. 11 and 11   a  are even less expensive to manufacture than embodiments of  FIG. 5   a.    
         [0131]      FIG. 6  shows an important feature, the film anchor-flap  510  which is a folded edge of film  500  that anchors the deployment door  190  to the bandage base  180 .  FIG. 6  is the same as  FIG. 4  except that an I.V. line extension  200  is shown adhered to the bandage base  180  near the film anchor-flap  510  of film  500  by an unseen adhesive. This drawing demonstrates one method of pre-stabilizing the I.V. line, prior to inserting the catheter. A film anchor-flap  510  is present on every embodiment.  
         [0132]      FIG. 7  shows an embodiment of the invention  700  wherein the deployment door  190  is narrower than the aperture. When this embodiment is deployed, a catheter, not shown, will be covered and stabilized by a band, rather than a complete layer, of bandaging film  500 . In this view, the deployment door  190  is viewed from the back, the non-adhesively coated, side  530  of film layer  500 . A medical extension tube  200  is threaded through a tube anchor  240 . Medical tube anchor  240  has an adhesive coating on the bottom surface so that before or after the device  700  is deployed, the tube can be anchored to skin or to an island  230 . The coating on the bottom of tube anchor  240  cannot be seen, but  FIG. 12   a , which shows anchor  240  in more detail and discloses a carrier paper layer on the bottom, protecting the unseen adhesive surface. The film anchor-flap  510  can be well visualized in this view.  
         [0133]      FIG. 8  is an embodiment that includes a tube anchor  240  that comprises an aperture or tunnel  245  with a section of a medical tube extension threaded  200  through it. This is the embodiment of  FIG. 7 , viewed from the front.  
         [0134]      FIG. 9  is a bottom view of the dressing with two absorbent pads  250  affixed to the adhesive coated bottom  110  of bandage base  180 . The plurality and the locations of the absorbent pads are arbitrary and non-limiting. The invention may have no absorbent pads or one or a plurality of pads  250  and the absorbent pads may be adhered to the film layer  500  or they may be adhered to the bandage base layer  180  and they may vary in size dramatically.  
         [0135]      FIG. 9   a  is a view of the dressing of  FIG. 9 , from the top side. This view shows locations where adhesive coatings, adhesive pads, or double sided tape can be placed  800   802  to use as tube anchor pads. In this view, a catheter adapter  220  is weakly affixed to the bandage base  180  by a small rectangle of adhesive  800  and an I.V. line  200  is anchored to bandage base  180  by an adhesive member 802. These adhesive members  800   802  are non-limiting examples of I.V. line anchoring means. A catheter  210  is seen in phantom because it is inserted under skin  400 . A male catheter adapter  220  is plugged into catheter female hub  215  and I.V. extension line  200  has a female luer adapter  205  on the receiving end.  802   
         [0136]      FIG. 10  is a close-up of the invention disclosing an alternate embodiment of the deployment door, the three-layer deployment door  195 . Three-layer deployment door  195  features a medical bandaging film  500  sandwiched in between two carrier paper layers  300   302 . The carrier papers  300   302  may be similar or they may be of very different varieties of carrier paper, wherein one is a heavy card thickness coated paper and the other is no more than a coated-on stiffening layer that can be peeled off during deployment.  
         [0137]      FIG. 10   a : This is the embodiment of  FIG. 10  with the top deployer  380  removed. This embodiment is used by removing deployer  380   FIG. 10 , thereby exposing the adhesive surface  520  of film  500 , the placing a catheter in the vessel, and then closing door  195 , now only two-layers, over the procedure site. This blankets the catheter and the bandage base with the adhesive surface  520  of film  500 . This immediately affixes the film to the catheter and to the dressing and stabilizes the catheter with stiffening layer  302  on top and extension  321  positioned so it can be grasped and pulled off of the dressing, leaving film  500  covering the catheter and the aperture.  
         [0138]     The basis for this invention is a specialization of the inventor&#39;s previous invention disclosed in application the inventor&#39;s pending utility application Ser. No. 10/906,630. The invention of that application is a preemptive invasive site dressing similar to that of  FIGS. 11 and 11 A. The 10/90660 dressing most commonly comprised an absorbent pad and this one most commonly does not. 10/906,630 does not speak to catheter anchoring, which is the essence of the present invention.  FIGS. 11 and 11 A a show an embodiment of the present invention that comprises a deployment door  190 . While the invention could not easily be packaged in this configuration without the addition of a carrier paper layer on the adhesive surface  520  of the film anchor-flap  510 , this embodiment does, in fact, speak to the heart of the invention and function as desired to preemptively secure a catheter. The embodiment of  FIGS. 11 and 11   a  are fully functional for the purpose of preemptively dressing an injection site or a catheterization site. The deployment door  190  comprises a bandaging film layer  500 , and a deployer  380 . The deployer further comprises a deployer body  325  and two retention legs  360   362  and the film layer  500  further comprises a film anchor-flap  510  and a flip-door  550 . The layer of bandaging film  500  is adhered to deployer  380  by adhesive surface  520  of said bandaging film  500 . A film anchor-flap  510  is located between the two retention legs  360   362 . When the deployment door  190  is placed on the catheterization site and folded back or cocked, as disclosed in 10/906630, it can be deployed over the catheter site to secure a catheter or over an injection site to cover the injection puncture.  
         [0139]     Since bandaging films of these type can be very thin and difficult to handle and because they tend to fold back upon themselves and stick to themselves is a way that makes their utility unrecoverable, a deployment door embodiment, similar to that of  FIGS. 11 and 11   a , is foreseen, comprising a 3-layer deployment door  195 , like that of  FIG. 10 . Three-layer films of this type are available commercially from 3M and Avery Label, Medical Tape Division.  
         [0140]      FIGS. 12 through 12   d  are examples of tube anchors that can be used in conjunction with the dressing.  FIG. 12  shows an anchor  240  that has an expansion retention ring or a medical tubing expansion retention anchor clamp  242  with a tension release tab or clamp handle  243 . An I.V. tube  200  is shown in cross section  202  threaded through the expansion retention ring or clamp  242 . The anchor  240  has a base  241  with an adhesive coated bottom—not visible. The adhesive coated bottom has a layer of release paper  304  releasably affixed to the bottom surface and release paper  304  has a pull-tab  306  to remove release paper  304  from the bottom of anchor  240 .  
         [0141]      FIG. 12   a  is the same as  FIG. 12  except that in  12   a , instead of the medical tubing expansion retention anchor clamp  242  shown in  FIG. 12 , this anchor  240  has a solid body  241  with a retention tunnel  245  though the body of tube anchor  240 . To use this anchor  240   FIG. 12   a , a tube  200  is threaded through tunnel  245  before catheter adapters are molded to the tube.  FIGS. 7 and 8  each show a tube  200  threaded through a tunnel of a tube anchor of this embodiment.  FIGS. 12, 12   a , and  12   b  show I.V. tube  200  in cross-section  202 .  
         [0142]      FIG. 12   b  is a tube anchor  240  that uses a plurality of flexible fingers to hold the I.V. tube in place. The flexible fingers or flanges  247  are visible in  FIG. 12   c  and are easier to see because the tube  200  in the tunnel  245  has been removed.  
         [0143]      FIG. 13  is a very elementary embodiment of the dressing  700  comprising only a film bandage base layer  500  and a piece of carrier paper  300 . The film bandage base layer  500  further comprises an anchor-flap  510  and an adhesive coating  520  on the underside of film  500  and a hinge  560 . Carrier paper layer  300  further comprises a deployer body  325  and a retention extension  320 . The deployer body  325  is part of the main body of carrier paper  300  up to where it bends and becomes retention extension  320 .  
         [0144]      FIG. 14  is a modified I.V. catheter  210  with a modification. Catheter  210  has a small flexible grabber extension  212  that parallels the needle. Said extension  212  remains outside the skin when the catheter is placed in the lumen of a blood vessel. The purpose of the extension is to extend the length of the extra-cutaneous physical presence of the catheter after the catheter has been placed. This results in bandaging film  500  having a larger target to grab when the dressing is deployed.  
         [0145]      FIG. 15  is a catheter adapter  220  with a catheter adapter grabber extension  225 .  
         [0146]      FIG. 15   a  is the male catheter adapter  220  of  FIG. 15  from a different angle so that the back or female hub receiver  215  is viewable. The relative length of the grabber extension is non-limiting. Grabber extensions which are larger or smaller or longer or shorter would still fall within the scope of the invention.  
         [0147]      FIG. 15   b  is the catheter adapter  220  of  FIGS. 15 and 15   a  on the I.V. tube extension of the embodiment of  FIG. 5 .