Patent Publication Number: US-2013228510-A1

Title: Highly uniform spunbonded nonwoven fabrics

Description:
TECHNICAL FIELD 
     The subject disclosure relates to catheter anchoring and supporting devices, and more specifically relates to catheter anchoring system, apparatus and method characterized by a removably mountable anchoring device for receiving a catheter hub of a catheter assembly, such that the anchoring device may be used as a guide to insert a cannula guide needle and associated cannula (e.g., intravenous cannula) of a catheter assembly into a patient&#39;s vein. Mounting the anchoring device to the patient limits movement of the catheter assembly in relation to the patient after cannula insertion. The anchoring device may dispose the catheter cannula at a preferred angle in relation to the patient. The anchoring device is shaped to facilitate asepsis when wrapped with an aseptic dressing. The subject disclosure is particularly relevant to aiding in the insertion of an intravenous (I.V.) cannula, increasing patient comfort and safety, reducing the risk of I.V. site contamination, and reducing the risk of patient infection. 
     BACKGROUND ART 
     A variety of catheter anchoring and supporting devices are discussed in the prior art. One example is a catheter anchoring and supporting device which has two adhesive members connected by an adhesive bridge to secure the members in a doubled over form when the two main members are used to position a catheter tube to a patient. Another example is catheter anchoring and supporting system that has an adhesively-attachable single-piece having two channels connected by a bridge, each channel for receiving a tubular segment. 
     However, these catheter anchoring and supporting system and devices do not address the desirable feature of aiding in the insertion of a catheter cannula into a catheter insertion site (e.g., a vein) of a patient. These catheter anchoring and support systems do not receive the hub of a catheter. Further, these catheter tube holders do not provide adequate adhesion between the patient&#39;s skin and the catheter insertion site to prevent a substantial displacement of the inserted cannula from the insertion site such as when any outward force is applied to the catheter tubing when moving a patient or when a patient is moving the area having the cannula inserted therein. 
     What is needed is an adhesively-attachable catheter anchoring apparatus having two side members and a cross-member therebetween, the cross-member having a retaining assembly integrated therein for receiving the catheter hub of a catheter assembly and for holding the associated cannula guide needle and the surrounding cannula at approximately a 3-degree angle (e.g., or any desired angle) and further having two vertically-oriented gripping tabs disposed on each side of the retaining assembly, to optionally be gripped while advancing the catheter assembly in the direction to pierce the vein with the cannula guide needle and to guide the cannula into a desired vein without requiring operator contact with the cannula or cannula guide needle, thus reducing the risk of an operator contaminating the catheter, thereby reducing the risk of patient infection, while also making starting the I.V. easier and faster. The present catheter anchoring apparatus addresses the foregoing needs by providing an adhesively-attachable H-shaped catheter anchoring apparatus with two side members and a cross-member there between, the cross-member having a retaining assembly integrated therein for receiving a catheter hub in a position desirable for insertion and for assisting in the advancement of a cannula guide needle into a patient&#39;s vein. 
     DISCLOSURE OF THE INVENTION 
     A simplified summary is provided herein to help enable a basic or general understanding of various aspects of exemplary, non-limiting embodiments that follow in the more detailed description and the accompanying drawings. This summary is not intended, however, as an extensive or exhaustive overview. Instead, the sole purpose of this summary is to present some concepts related to some exemplary non-limiting embodiments in a simplified form as a prelude to the more detailed description of the various embodiments that follow. 
     An embodiment of the present catheter anchoring system, apparatus and method includes a rectangular first side member having an upper portion, a lower portion, an inner side, and an outer side. A rectangular second side member is in a closely-spaced, parallel relation to the rectangular first side member. The second side member has a top portion, a bottom portion, an inner edge and an outer edge. A cross-member is located between the first side member and the second side member, such that the apparatus attains an H-shaped configuration. The cross-member is substantially rectangular having a top side, a bottom side, an outer first edge, an outer second edge, a front edge, and a rear edge. A retaining assembly is located on the cross-member with a longitudinally positioned channel inside for removably securing a catheter hub. When the apparatus is placed on a patient&#39;s arm, the retaining assembly has a right side and a left side. The retaining assembly is mounted to the center of the top side of the cross-member. A plurality of retaining fingers is mounted to the right side and the left side of a retaining assembly. A first gripping tab is mounted to the top side of the cross-member in vertical relation to it and between the retaining assembly right side and the outer first edge of the cross-member. A second gripping tab is mounted to the top side of the cross-member in vertical orientation to the top side and between the retaining assembly left side and the outer second edge of the cross-member. A vertical tab is mounted to the top side of the cross-member. The first side member and the second side member are in vertical orientation thereto and between the outer side of the first side member and the outer edge of the second side member. The vertical tab has a front face, a rear face, and a bottom edge surface. The bottom edge surface is connected to the top side of the cross-member. The first side member and the second side member are in parallel relation to the front edge. Adhesive for an adhesive layer is bonded to a bottom surface of the apparatus. The adhesive is selected from a class of adhesives that are suitable for use on human skin. A backing removably covers the adhesive layer. According to an embodiment, the backing has additional, continuous backing that is substantially the same size as the size of backing that removably cover the adhesive layer. The additional backing is folded over the backing. The additional backing extends to the side of the catheter apparatus opposite the fold. A backing removal extension piece, that is attached to the backing, extends beyond the catheter apparatus for removal of the backing through the act of pulling the backing removal extension piece, the attached additional backing, and exposing the attached backing. 
     Another embodiment of the present catheter anchoring system, apparatus and method is provided to securely anchor a catheter to a site on a patient&#39;s skin. The device has a flexible, rectangular first side member with an upper portion, a lower portion, an inner side, and an outer side and a flexible, rectangular second side member with a top portion, a bottom portion, an inner edge, and an outer edge. The side members are adapted to be secured to the skin of a patient in closely-spaced, parallel relation. The device further features a rigid cross-member having top side, a bottom side, an outer first edge, an outer second edge, a front edge, and a rear edge. The outer first edge is affixed to the center of the upper portion, near the inner side of the first side member and the second edge affixed to the center of the top portion, near the inner edge of the second side member. A retaining assembly has a longitudinally disposed channel therein for removably securing a catheter adaptor. The retaining assembly is mounted to the center of the top side of the cross-member. An indention in the rear edge of the cross-member is adjacent to the retaining assembly. The indention is configured to allow a catheter hub to be removably secured within the channel. A first gripping tab is mounted to the top side of the cross-member in a vertical relation thereto and between the retaining assembly right side and the first edge of the cross-member. The first gripping tab has a front side, a rear side, and a bottom edge. The bottom edge is affixed to the top side of the cross-member in a parallel position in relation to the front edge. A second gripping tab is mounted to the top side of the cross-member in vertical relation thereto and between the retaining assembly left side and the second edge of the cross-member. The second gripping tab has a front wall, a rear wall and a lower edge. The lower edge is affixed to the top side of the cross-member in a parallel position in relation to the front edge. An adhesive layer is located on the lower portion of the first side member, on the bottom portion of the second side member, and on the cross-member. A backing removably covers the adhesive layer. The backing includes a backing removal extension piece. 
     To use the present device, before insertion of the catheter, the hub of the catheter is snapped into the retaining assembly by the user, such as a nurse or physician. Then, gripping one of the tabs on either side of the retaining assembly, depending on the dominant hand of the user, the catheter is advanced after locating and piercing the vein with a cannula guide needle. Using the tabs to advance the catheter reduces the risk of an operator contaminating the catheter and passing bacteria to the patient because the operator&#39;s gloved fingers would not come into direct contact with the catheter itself or the cannula. Conventionally, a user uses a thumbnail to push on a ridge of the hub of the catheter thereby making it very easy to contaminate the catheter by touching the catheter (e.g., cannula) before it enters the vein, which may occur even more often when the catheter operator has large fingers. After the catheter is in place, the operator holds one of the tabs while attaching, for example, a saline lock or I.V. tubing with the other hand. The side members and cross-member are then slightly lifted as the backing is removed, and then the entire apparatus is pressed down to secure the device to a patient&#39;s skin. This device is much less cumbersome than securing a catheter into place with tape, particularly when the nurse or physician is wearing gloves. In addition, the present device reduces a patient&#39;s pain when moving about because the catheter and I.V. do not pull at the site of the insertion. 
     As such, the general purpose of the improved catheter anchoring system, apparatus and method which has all of the advantages of the prior art mentioned heretofore and many novel features that result in an improved catheter anchoring system, apparatus and method which is not anticipated, rendered obvious, suggested, or even implied by the prior art, either alone or in combination thereof. 
     An object of the present catheter tube anchoring device to reduce the risk of contamination of a catheter through contact with non-sterile surfaces, thereby reducing the risk of patient infection. 
     Another object of the present catheter tube anchoring device is to make the starting of an I.V. much easier and faster than permitted by prior art devices. 
     Yet another object of the present catheter tube anchoring device is to easily secure a catheter to a patient&#39;s skin. 
     Still further, another object of the present catheter tube anchoring device is to substantially immobilize the IV to the skin of a patient, thereby reducing pain caused by movement of the IV in relation to the patient. 
     Thus has been broadly outlined the more important features of the improved catheter tube anchoring device so that the detailed description thereof that follows may be better understood and in order that the present contribution to the art may be better appreciated. 
     The above-described deficiencies of today&#39;s systems for catheter anchoring are merely intended to provide an overview of some of the problems of conventional systems, and are not intended to be exhaustive. Other problems with the state of the art and corresponding benefits of some of the various non-limiting embodiments may become further apparent upon review of the following detailed description. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various non-limiting embodiments are further described with reference to the accompanying drawings in which: 
         FIG. 1  is a schematic isometric top view of an embodiment of the catheter anchoring system, apparatus and method, according to an embodiment. 
         FIG. 2  is a schematic perspective right side view of an embodiment of the present disclosure. 
         FIG. 3  is a schematic isometric bottom view of an embodiment. 
         FIG. 4  is a schematic isometric bottom view of an embodiment. 
         FIG. 5  is a schematic top view of an embodiment. 
         FIG. 6  is a schematic bottom view of an embodiment. 
         FIG. 7  is a schematic right side view of an embodiment. 
         FIG. 8  is a schematic front view of an embodiment. 
         FIG. 9  is a schematic back view of an embodiment. 
         FIG. 10   a  is a schematic side view of a catheter hub according to an embodiment. 
         FIG. 10   b  is a cross sectional view along the line  10   b - 10   b  of  FIG. 9 . 
         FIG. 11  is a schematic isometric top view of an embodiment having a catheter hub inserted therein. 
         FIG. 12  is a schematic perspective rear view of an embodiment having a catheter hub inserted therein. 
         FIG. 13   a  is a schematic isometric top view of an embodiment containing a winged catheter hub attachment. 
         FIG. 13   b  is a schematic perspective rear view of an embodiment containing a winged catheter hub attachment. 
         FIG. 13   c  is a schematic top view of an embodiment containing a winged catheter hub attachment. 
         FIG. 14  is a schematic in-use drawing of a catheter hub and associated cannula and need being snapped into an embodiment. 
         FIG. 15  is a schematic in-use drawing of a method for locating the needle of a catheter on the surface of a patient&#39;s skin, according to an embodiment. 
         FIG. 16  is a schematic in-use drawing of a method for removing the needle while advancing the cannula of the catheter into a patient&#39;s skin, according to an embodiment. 
         FIG. 17  is a schematic in-use drawing of a method of attaching a medical accessory to the catheter hub, according to an embodiment. 
         FIG. 18  is a schematic in-use drawing of a method of attaching a providing additional securement to an embodiment with the use of adhesive medical strips. 
         FIG. 19  is a schematic top view of an embodiment additionally secured with adhesive medical strips. 
         FIG. 20  is a schematic in-use drawing of an embodiment as it is secured to the skin with an adhesive backing, holding the cannula of a catheter hub in place with a medical accessory attached to the catheter hub. 
         FIG. 21  is a schematic front-right perspective view of an embodiment having an integrated catheter hub and a cannula extending therefrom. 
         FIG. 22  is a schematic rear-left perspective view of an embodiment. 
         FIG. 23  is a schematic top view of an embodiment. 
         FIG. 24  is a schematic bottom view of an embodiment. 
         FIG. 25  is an isometric top view of an embodiment. 
         FIG. 26  is an isometric bottom view of an embodiment. 
         FIG. 27  is a top plan view of an embodiment. 
         FIG. 28  is a cross-section view of an embodiment taken along line  4 - 4  of  FIG. 27 . 
         FIG. 29  is an isometric in-use view of an embodiment. 
         FIG. 30  is an isometric top view of an embodiment. 
         FIG. 31  is an isometric bottom view of an embodiment. 
     
    
    
     BEST MODES FOR CARRYING OUT THE INVENTION AND INDUSTRIAL APPLICABILITY 
     Overview 
     The claimed subject matter is now described with reference to the drawings, wherein like reference numerals are used to refer to like elements throughout. In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of the claimed subject matter. It may be evident, however, that the claimed subject matter may be practiced without these specific details. In other instances, well-known structures and devices may be shown in block diagram form in order to facilitate describing the claimed subject matter. 
     Moreover, the word “exemplary” is used herein to mean serving as an example, instance, or illustration. Any aspect or design described herein as “exemplary” is not necessarily to be construed as preferred or advantageous over other aspects or designs. Rather, use of the word exemplary is intended to present concepts in a concrete fashion. As used in this application, the term “or” is intended to mean an inclusive “or” rather than an exclusive “or.” Therefore, unless specified otherwise, or clear from context, “X employs A or B” is intended to mean any of the natural inclusive permutations. That is, if X employs A; X employs B; or X employs both A and B, then “X employs A or B” is satisfied under any of the foregoing instances. In addition, the articles “a” and “an” as used in this application and the appended claims should generally be construed to mean “one or more” unless specified otherwise or clear from context to be directed to a singular form. 
     With reference now to the drawings, and in particular  FIGS. 1 through 31  thereof, various embodiments employing the principles and concepts of the present catheter anchoring system, apparatus and method, generally designated by the reference number  10 , will be described. 
     Referring to  FIGS. 1 through 31 , various embodiments of the present catheter anchoring system, apparatus and method  10  are used to secure a catheter assembly (e.g., including a cannula placed in the skin and a medical attachment such as intravenous tubing connected to a hub in fluid communication with said cannula) to a patient. The present apparatus  10  provides a rectangular first side member  20 , a rectangular second side member  40  in closely-spaced, parallel relation to the first side member  20 , and a cross-member  60  there between thereby forming an H-shaped configuration, according to some embodiments. It is recognized by those skilled in the art that the cross-member  60  may be placed at any location along the parallel side members according to some embodiments. The first side member  20  has an upper portion  22 , a lower portion  24 , inner side  26 , and an outer side  28 . The second side member  40  has a top portion  42 , a bottom portion  44 , an inner edge  46 , and an outer edge  48 . 
     According to an embodiment shown in  FIGS. 25 through 31 , the generally rectangular cross-member  60  has top side  62 , a bottom side  64 , an outer first edge  66 , an outer second edge  68 , a front edge  70 , and a rear edge  72 . The outer first edge  66  is attached to the inner side  26  of the first side member  20 . The outer second edge  68  is attached to the inner edge  46  of the second side member  40 . According to an embodiment, the outer first edge  66  is attached at any point along the inner side  26  of the first side member  20 , such that the cross-member  60  and the outer first edge  66  are in a substantially perpendicular configuration. The outer second edge  68  is attached at any point along the inner edge  46  of the second side member  40 , such that the cross-member  60  and the outer second edge  68  are in a substantially perpendicular configuration. 
     According to an embodiment as shown in  FIGS. 1 through 31 , the present apparatus is constructed from a single polymer having operational elastomeric characteristics such that the apparatus is selectively flexible according to the type of polymer chosen. One application of a flexible apparatus is that a single design (e.g., an apparatus configuration of a single size) of the apparatus can adapt to (e.g., fit) a greater percentage of patients&#39; arms (e.g., appendages). Another application of a flexible apparatus is to increase usability in situations where a patient&#39;s skin may be very tender and sensitive to the placement of rigid or ill-fitting medical devices on their body. A substantial benefit is realized by having the ability to change the composition of the polymer used as the substrate for the apparatus and as a result, directly change the operational elastomeric characteristics of the apparatus as a whole. As might be expected, the possible applications of this ability are numerous. According to some embodiments, the use of more than one polymer is contemplated, for example, for creating a soft surface to be placed against a patient&#39;s skin and a rigid surface to receive the catheter hub. Other such combinations of more than one polymer are possible for a variety of purposes, but are not illustrated here. 
     Corners  128  (e.g., where edges of two side members meet) of the first and second side members, according to an embodiment, are trimmed (e.g., by filleting, chamfering or any other suitable technique) such that the corners do not catch on dressings or other materials that might be placed in contact with the first and second side members. The edges  129  of the first and second side members, similarly, are ground down (e.g., buffed, radiused) in order to reduce the sharpness of the edges, so that the edges to not catch on or damage dressings or other materials that might be placed in contact with the first and second side members. 
     The top or upper portions of an embodiment of the first or second side members contains at least one longitudinally scored portion  120 , parallel to a longitudinal edge (e.g., an edge that runs perpendicular to the cross-member), to increase flexibility of the primary support structure at that scored portion  120 . According to an embodiment, two scored portions  120  are employed such that one scored portion  120  extends from the top portion of the first side member a distance downwards into the first side member and the second scored portion  120  extends from the upper portion of the second side member a distance downwards into the second side member. The scored portions  120  are disposed in a parallel configuration with each other and with a longitudinal edge of the first and second side members. The position, depth and number of the scored portions  120  is chosen to increase or decrease lateral flexibility (e.g., flexibility along a line parallel to the cross-member) of the first and second side members without modifying the polymer from which the apparatus is constructed. For example, the scored portions  120  may extend from a top portion downward into the first side member a distance of approximately 0.8 millimeters. According to other embodiments, the range of the depth of the scored portions  120  may range from 0 millimeters to 1.5 millimeters. According to an even further embodiment, the range may be from 0.5 millimeters to 1 millimeter. According to an even further embodiment, the range may be from 0.7 millimeters to 0.9 millimeters. The scored portions  120  reduce the strength of the polymer at the scored portions  120 , allowing the outermost edges of the first and second side portions to be bendable (e.g., acting as wings that can be bent to conform to a patient&#39;s arm). One advantage of bending the first and second side portions might be to more readily secure the assembly by surrounding an appendage of a patient with the retaining assembly  80 . 
     According to an embodiment, a retaining assembly  80  having a longitudinally disposed channel  82  therein is configured to removably secure a catheter hub  100  (e.g., catheter adaptor). The retaining assembly  80  is mounted to the center of the top side  62  of the cross-member  60 . The retaining assembly  80  is attached to the cross-member  60  so that the catheter hub  100  is held at a 3-degree angle  87  to increase patient comfort. According to various other embodiments, the retaining assembly  80  could hold the catheter hub  100  at any desired angle in relation to the cross-member  60 . According to further embodiments, the retaining assembly could hold a catheter hub of any desired size. 
     According to an embodiment, the retaining assembly  80  has a right side  84  and a left side  85 . The position of the retaining assembly  80  in the center of the top side  62  of the cross-member  60  balances the retaining assembly  80  in a central position not only for patient comfort while the catheter apparatus  10  is moved about, but also for aiding removal of backing  30  from an adhesive layer  99  to secure the apparatus  10  to a patient  200  without jarring the position of the catheter assembly, thus further increasing patient comfort. The adhesive for the adhesive layer  99  is selected from a class of adhesives that are suitable for use on human skin. Various adhesives can be chosen for various embodiments depending on the degree of adhesion required and other factors (e.g., type of skin to be used on, length of time the adhesive must remain adhered). 
     According to an embodiment, an indention  90  in the rear edge  72  of the cross-member  60  and adjacent to the retaining assembly  80  is optionally configured to allow a catheter hub  100  to be removably secured within the channel  82 . Optionally, an indention  90  increases the ease with which a catheter hub  100  is inserted into the retaining assembly  80 . Insertion of a catheter hub  100  in to the retaining assembly  80  is aided by the presence of the indention  90  in the cross-member  60  when compared to a retaining assembly  80  affixed to a cross-member  60  without the indention  90 . 
     According to an embodiment, the retaining assembly  80  has a plurality of retaining fingers  110  that mount to the right side  84  and the left side  85  of the retaining assembly  80 . These retaining fingers  110  (e.g., retaining members) may number four, and may be positioned at a longitudinal end of the retaining assembly  80 . The retaining fingers extend away from the right side  84  and the left side  85  in a circular manner, essentially “grabbing” a catheter hub  100  as it is inserted into the retaining assembly  80 , and acting to securing the catheter hub  100 , preventing the catheter hub  100  from being removed from the retaining assembly  80 . 
     According to an embodiment, a three-dimensional support structure  112  surrounds, and is integrated (e.g., molded) or otherwise part of the retaining assembly  80 . The support structure  112  includes a substantially triangular, sloped element  114  integrated into both sides of the retaining assembly  80  in order to integrate the retaining assembly  80  with the cross-member  60  and prevent it from moving in relation to the catheter apparatus  10 . In addition to physically supporting the retaining assembly  80 , the sloped elements&#39; primary sloped surface  116  is adapted to receive an adhesive backed surface of aseptic tape or of an aseptic dressing, so that the adhesive backed surface can be adhered (e.g., sealed) substantially continuously to the sloped surfaces, forming a shield between the surrounding environment and the retaining assembly, preventing bacteria from reaching the catheter insertion site. 
     According to an embodiment, a first gripping tab  50  is mounted to the top side  62  of the cross-member  60  in vertical relation thereto and between the retaining assembly right side  84  and the outer first edge  66  of the cross-member  60 . The first gripping tab  50  has a front side  51 , a rear side  52  and a bottom edge  53 . The bottom edge  53  is affixed to the top side  62  of the cross-member  60  in parallel position in relation to the front edge  70 . A rigid second gripping tab  55  mounted to the top side  62  of the cross-member  60  in vertical relation thereto and between the retaining assembly  80  left side  85  and the outer second edge  68  of the cross-member  60 . The second gripping tab  55  has a front wall  56 , a rear wall  57 , and a lower edge  58 . The lower edge  58  is affixed to the top side  62  of the cross-member  60  in parallel position in relation to the front edge  70 . The gripping tabs reduce the risk of contaminating the catheter by preventing direct contact of the operator&#39;s fingers with the catheter itself. Thus, the risk of infecting a patient  200  is mitigated. The use of the gripping tabs  50 ,  55  for advancing the catheter apparatus  10  and associated cannula guide needle  101  into the patient&#39;s  200  vein reduces the likelihood of contamination and potential for patient infection. In an embodiment, each of the first gripping tab  50  and the second gripping tab  55  have a triangular prism shape which has the same footprint as the preferred embodiment first gripping tab  50  and the second gripping tab  55 . In this embodiment each of the first gripping tab  50  and the second gripping tab  55  have an internal cavity  54  therein and a rectangular front side  51 ,  56  perpendicular to the cross-member  60 , as shown in  FIG. 6 . During use the front side  51 ,  56  of each of the first and second gripping tabs  50 ,  55  faces the user. 
     According to an embodiment, a vertical tab  118  is mounted to the top side  62  of the cross-member  60 , the first side member  20  and the second side member  40 , in vertical relation thereto, and between the outer side  28  of the first side member and the outer edge  48  of the second side member. The vertical tab  118  has one or more longitudinally scored portions  120 , each perpendicular to the cross-member  60  and positioned adjacent to the scored portions  120  in the first side member  20  and the second side member  40 . The width of the longitudinally scored portions  120  matches the width of the scored portions  120  in the first side member  20  and the second side member  40 . The vertical tab  118  is integrally mounted around the retaining assembly  80  such that it does not interfere with access to the channel  82  of the retaining assembly  80 . The vertical tab  118  has a front face  122 , a rear face  124 , and a bottom edge surface  126 . The bottom edge surface  126  is affixed to the top side  62  of the cross-member  60 , the first side member  20  and the second side member  40  in parallel position in relation to the front edge  70 . The front face  122  of the vertical tab  118  is adapted to receive the adhesive backed surface of aseptic tape or of an aseptic dressing, so that the adhesive backed surface can be adhered substantially continuously to the vertical tab  118 . Combined with the sloped elements  114 , a shield may be formed around the retaining assembly  80 , preventing foreign particles (e.g., bacteria) from entering the catheter insertion site, and also possibly preventing infection. 
     According to an embodiment, the vertical tab  118  also reduces the risk of contaminating the catheter hub  100  by preventing direct contact of the operator&#39;s fingers with the catheter hub  100  or catheter itself. Thus, the risk of infecting a patient  200  is reduced. The use of the rear face  124  of the vertical tab  118  for advancing the cannula guide needle  101  (e.g., placing an operator&#39;s fingers only on the rear face  124  in order to advance the guide needle and surrounding cannula) into the patient&#39;s  200  vein reduces the likelihood of contamination and potential for patient  200  infection. Additionally, use of only the rear face  124  maintains the front face  122  in an aseptic condition for when a dressing is placed over the retaining assembly  80 . 
     An adhesive layer  99 , shown in  FIGS. 3 ,  8  and  26  according to an embodiment, is disposed on the lower portion  24  of the first side member  20 , on the bottom portion  44  of the second side member  40 , and on the bottom side  64  of the cross-member  60 , permits the apparatus  10  to be secured to a patient&#39;s skin more quickly and easily than securement with tape, although some embodiments, shown in  FIGS. 18 and 19 , employ medical tape strips to provide for further securement of the retaining assembly  80  once the adhesive layer is exposed. In an embodiment, a backing  30  may cover the adhesive layer  99  so that the catheter apparatus  10  can be positioned without exposing and seating the adhesive layer  99 . The backing  30  may be one continuous backing that is folded over, such that the folded over portion extends to the side of the catheter apparatus  10  opposite the folded over portion, where a backing removal extension piece extends beyond the catheter apparatus  10  for removal of the backing through the act of pulling the backing removal extension piece  35 . In an embodiment, an absorbent pad  105 , which is disposed on the entire bottom side  64  of the cross-member  60 , the first side member  20  and the second side member  40 , is substituted for the adhesive layer  99 . 
     According to an embodiment, a pressure-released polymer adhesive-containing capsule  107  is disposed within the internal cavity  54  of each of the first and second gripping tabs  50 ,  55 . Each of the capsules  107  has a diameter of approximately ⅛ inch. According to an embodiment, in use, when securing the alternative embodiment of the apparatus  10  to the patient, the user places pressure on the first and second gripping tabs  50 ,  55  to break open the capsules  107  therein and to release the polymer adhesive which passes through mesh openings  108  disposed on an bottom edge  53  of each of the first and second gripping tabs  50 ,  55  to permeate the absorbent pad and then onto user&#39;s skin to adhere the apparatus  10  onto the patient&#39;s skin. Alternatively, the polymer adhesive is released onto and through the absorbent pad  105  onto the patient&#39;s skin and then combines with a second adhesive which has already been applied to the patient&#39;s skin, prior to the polymer adhesive, and the combination thereof secures the apparatus  10  onto the patient&#39;s skin. 
     According to an embodiment, a backing  30 , which removably covers the adhesive layer  99  has a rectangular first part  31 , a rectangular second part  32 , a L-shaped third part  33 , and a L-shaped fourth part  34 . The first part  31 , second part  32 , third part  33 , and fourth part  34 , each having a backing removal extension piece  35 . In the alternative embodiment, the backing  30  removably covers the absorbent pad  105 . 
     According to an embodiment, an adhesive layer  99  is disposed on the lower portion  24  of the first side member  20 , on the bottom portion  44  of the second side member  40 , and on the bottom side  64  of the cross-member  60 . The adhesive layer  99  may be applied to the lower portion  24 , the bottom portion  44 , or the bottom side  64  at separate times or at the same time. A backing  30  is disposed on the adhesive layer  99  (e.g., the portion of the adhesive layer opposite the lower portion  24 , bottom portion  44 , or bottom side  64 ) such that removal of the backing  30  will expose the adhesive layer  99 , enabling an un-backed portion of the apparatus to be adhered to a surface. The backing  30  of the adhesive layer  99  may cover the entire adhesive layer  99  or be scored and separated into multiple portions for ease of de-backing when the apparatus is placed in close proximity to the surface of a patient&#39;s skin. One or more backing removal extension pieces  35  of the backing  30  may extend past an edge of the apparatus so that an operator can grasp the backing removal extension piece  35 , and easily remove the backing  30  from the adhesive layer  99  underneath. 
     According to an embodiment, a spring-loaded push-release button  110  is disposed atop an attachment end of a plastic housing  112  into which the cannula guide needle  101  is retracted. 
     An embodiment that can be used with a catheter having winged attachments, such as the BD Nexiva™ brand closed IV catheter system, commercially available from Beckton, Dickinson and Company of Franklin Lakes, N.J., is shown in  FIGS. 13   a  through  13   c.    
     Operation, According to Various Embodiments 
     As shown in  FIGS. 14 through 20 , according to an embodiment, to use the present apparatus  10 , an operator, such as a nurse or physician, begins by placing a catheter hub  100  securely into the retaining assembly  80  before inserting an attached cannula guide needle  101  into a patient.  FIG. 9  shows a rear view of the catheter apparatus  10 , and  FIG. 10   b  shows a cut-away view of  FIG. 9 , along the line  10 - 10 .  FIG. 10   a  shows the catheter hub and  FIG. 10   b  shows where the catheter hub  100  is to be received.  FIG. 11  shows an example of one type of catheter hub that can be secured by the catheter apparatus  10 .  FIGS. 12 and 14  shows that hub inserted into the retaining assembly of the catheter apparatus  10 . The operator then proceeds by locating and piercing the patient&#39;s  200  vein with a cannula guide needle  101  of the catheter hub  100 . Then, gripping either the first gripping tab  50  or second gripping tab  55 , an operator advances the cannula guide needle  101  into a patient&#39;s  200  vein. After the cannula guide needle and associated cannula is desirably inserted into the vein, the operator grips either the first gripping tab  50  or second gripping tab  55 , depending on the operator&#39;s dominant hand, while attaching corresponding I.V. tubing with the operator&#39;s other hand. 
     According to an embodiment, to secure the apparatus  10  to the patient&#39;s skin, the operator slightly lifts the cross-member  60  while removing the backing  30  by pulling on the backing extension piece  35 . After removing the backing  30 , the user presses down on the cross-member  60 , first side member  20 , and second side member  40  to secure the apparatus  10  to a patient  200 . 
     According to an embodiment shown in  FIGS. 14 through 20 , a user selects a site on the patient  200  for the site of the catheter (e.g., and catheter apparatus  10 ) and prepares the site according to a predetermined procedure. A tourniquet is applied to the arm of the patient  200  at a point above the IV insertion point. The catheter hub  100  of an intravenous catheter (e.g., still attached to the I.V. starting device, such as a cannula guide needle  101 ) is placed into the retaining assembly  80  where it becomes removably attached to the catheter apparatus  10 . With the catheter apparatus  10  and catheter hub  100  assembled, the vein is pierced with the cannula guide needle  101 . A thumb and forefinger can then be used to grasp the vertical tab  118  on either side of the catheter hub  100  so that a force in the direction of the vein can be applied to the catheter apparatus  10 , causing the catheter (e.g., the cannula of the catheter and the cannula guide needle) to advance into the vein. At this point, the catheter assembly will be resting on the skin of the patient. As the cannula guide needle  101  is retracted, the catheter apparatus  10  is held in place by the vertical tab  118 . Ancillary catheter tubing is then secured, and the tourniquet is removed from the arm of the patient  200 . The catheter apparatus  10  is secured when the user pulls on the backing removal extension piece  35 , uncovering the adhesive layer on the underside of the catheter apparatus  10 , enabling the adhesive layer to come into contact with the skin. 
     According to an embodiment, addition securement can be provided by placing securement tape (e.g., steri-strips, medical tape strips) over the apparatus  10  and the attached catheter hub  100 . An example of one method of providing additional securement to the apparatus is shown in  FIG. 19 . 
     According to other embodiments, for securing the device to the patient&#39;s skin, the user slightly lifts the cross-member  60  while removing the backing  30  from the lower side  109  of the absorbent pad  105  by pulling on a corresponding extension piece. The user then places pressure on the first and second gripping tabs  50 ,  55  to break open the capsules  107  and to release the polymer adhesive through the mesh openings  108  to permeate the absorbent pad, and then onto to the user&#39;s skin to adhere the apparatus  10  onto the patient&#39;s skin. Alternatively, the polymer adhesive is released onto and through the absorbent pad  105  onto the patient&#39;s skin and then combines with a second adhesive which has already been applied to the patient&#39;s skin, prior to the polymer adhesive, and the combination thereof secures the apparatus  10  onto the patient&#39;s skin. To retract the cannula guide needle, the user pushes the spring-loaded push-release button  110  disposed atop an attachment end of the plastic housing  112  in some embodiments. 
       FIGS. 21 through 24  illustrate an embodiment in which the catheter apparatus  10  is an integrated part of a catheter, such that the catheter hub  100  is integrated into (e.g., molded into) the apparatus  10 . A cannula is shown extending from an end of the catheter hub, ready for insertion into a vein of a patient. 
     The word “exemplary” is used herein to mean serving as an example, instance, or illustration. For the avoidance of doubt, the subject matter disclosed herein is not limited by such examples. In addition, any aspect or design described herein as “exemplary” is not necessarily to be construed as preferred or advantageous over other aspects or designs, nor is it meant to preclude equivalent exemplary structures and techniques known to those of ordinary skill in the art. Furthermore, to the extent that the terms “includes,” “has,” “contains,” and other similar words are used in either the detailed description or the claims, for the avoidance of doubt, such terms are intended to be inclusive in a manner similar to the term “comprising” as an open transition word without precluding any additional or other elements. 
     In view of the exemplary apparatus and methods described supra, methodologies that may be implemented in accordance with the disclosed subject matter will be better appreciated with reference to the flowcharts of the various figures. While for purposes of simplicity of explanation, the methodologies are shown and described as a series of blocks, it is to be understood and appreciated that the claimed subject matter is not limited by the order of the blocks, as some blocks may occur in different orders and/or concurrently with other blocks from what is depicted and described herein. Moreover, not all illustrated blocks may be required to implement the methodologies described hereinafter. 
     While the various embodiments have been described in connection with the preferred embodiments of the various figures, it is to be understood that other similar embodiments may be used or modifications and additions may be made to the described embodiment for performing the same function without deviating therefrom. Therefore, the present invention should not be limited to any single embodiment, but rather should be construed in breadth and scope in accordance with the appended claims.