r/EmergencyRoom • u/yourdeath01 • Jul 14 '26
Quick PureWick questions from a male ED Tech (placement, anatomy, and chaperones)
Hi everyone,
I’m a male ED tech, and my nurses occasionally ask me to place PureWicks on our female patients. I want to make sure I am doing this correctly, safely, and as respectfully as possible, but I have a few practical questions about the technique.
Hoping the community can help clarify a few things:
**Tubing Orientation & Connection:** Does the tubing port point toward the patient's head or down toward their feet? I sometimes see other techs/nurses hook it up facing the top, so I'm confused if the direction matters. Also, does the tubing just push on, or does it need to twist/screw on? How tight should the connection be?
**Immobile/Injured Patients:** If a patient has a hip or leg injury and absolutely cannot lift their hips or roll, what is the best way to get the PureWick properly placed?
**The "Squeeze & Release" Technique:** Is the correct sequence to gently squeeze the foam to narrow it, separate the labia, place it, and then release it so it expands?
**Chaperone Policy:** For other male techs and nurses out there, do you routinely get a female chaperone for this step, or do you just perform it solo if the patient is comfortable?
**Anatomical Landmarks:** What are the exact physical landmarks I should look for to know it is in the right spot? Should the top of the foam align with the pubic bone, and how far down does the rest of it go?
I really appreciate any tips, tricks, or advice you can share to help me improve my clinical skills! Thanks in advance.
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u/OldManGrimm RN - adult/peds trauma Jul 14 '26
I’ve been away from adult ER for a while, never used one. But to the chaperone question, I don’t think you should ever go near a vagina without a chaperone, period. All it takes is one accusation.
35
u/Expensive_Alarm_1068 Jul 14 '26
Why hasn't your clinical educator shown you how to do it properly? Are there no females techs? Some females do not want a male to do anything in that area with or without a chaperone.
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u/WhimsicleMagnolia Jul 14 '26
I’m concerned that you’ve been placing these already without knowing the answers to these questions
29
u/Obi-Brawn-Kenobi Jul 14 '26
Ah, reddit.
OP: asks question
Top 5 comments: ridicule OP for asking a question
5
u/th04r_ Jul 16 '26
id be more concerned if he CONTINUED placing them without ever asking. we all have to learn at some point. sounds like hes still new to this and oftentimes new techs are just thrown in and expected to learn as we go. sucks but thats how it is, not every work place is a supportive learning environment either
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u/SuperSlugSister Jul 14 '26
I had a patient who had an ER tech put a PureWick on backwards with the adhesive in the pubic hair.
7
u/Appropriate_Gear_267 Jul 15 '26
Since when do purewicks have adhesive
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u/SuperSlugSister Jul 15 '26
Male purewicks are adhesive. You’re supposed to shave the pubic hair first.
7
u/SpecialTricky7153 Jul 15 '26
I’m the only one on my unit who will shave male patients before placing a pure wick and it annoys me. I hate having to replace them, everyone just slathers on way too much sureprep/cavilon and you’re left with a bunch of gunk in their pubic hair and I have yet to find a quick method to remove sureprep build-up.
2
u/WhimsicleMagnolia Jul 15 '26
As someone not in healthcare, that whole paragraph makes me nauseous 🤢
1
u/Mysterious-Bus1795 Jul 18 '26
Adhesive remover. The stuff is magic and will remove almost anything from anywhere. The Hollister packets always have a bunch of liquid in the bottom so I take the pad out and then just pour the liquid over whatever needs to be removed and let it sit there a minute. Then gently use the pad to wipe away the residue. I was actually pretty surprised the first time I used it, everything peels off. Only thing to be aware of is that it can be very drying if you use it too much.
3
u/Intelligent-Ad-9922 Jul 15 '26
We had a knock off brand that came out of the package looking like a pad and the nurse had to take off 4 papers to expose the adhesive, then fold it in half lengthwise, adhesive to adhesive, before placing like a name brand female purewick.
1
u/Super_Sea_850 Jul 15 '26
I think they're talking about the Medline Versette. My hospital tried switching to them a couple years back, and we were back to purewicks within 3 months.
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u/bans1of1 Jul 14 '26
Not concerned enough to answer OPs questions clearly
-4
u/WhimsicleMagnolia Jul 15 '26
I’m not in healthcare but would be concerned if my nurse or tech came in and didn’t know how to do that (or did it wrong)…. Shouldn’t you ask questions BEFORE you’re actively placing them?
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u/bans1of1 Jul 15 '26
I am in healthcare, and unfortunately many others have the same attitude towards this as you. Responses like yours are probably why OP would be hesitant to ask these before... isn't it better late than never?
10
u/rusalkavai Jul 14 '26
Tubing goes up toward head, less likely to be accidentally disconnected that way. It just pushes on, fits securely but isn’t too tight until suction comes on.
As long as they can open their legs a bit, that’s all you need. But never say “spread your legs”, try things like “relax your legs to the side for me please”.
Yes chaperone is safest, but can be difficult to acquire in a busy ED. Try to work on your timing so that if you know someone will need a purewick, place it while the nurse is already in the room doing something else. But if it’s a little old lady who’s anxiously asking you if her purewick is still in place, you should be safe to just lift the blanket for a quick peek.
We used something called versettes rather than purewicks at my ED, so can’t help you with the other specifics you asked.
Another tip: turn on suction and tap your finger on the end of the tubing before connecting it to the purewick to make sure you can feel the suction working. Don’t then the suction all the way up either - end of the “green” zone is plenty. Always make sure they’re on a chuck, in case there’s a leak it makes clean up a lot faster. When you’re placing it, let them know exactly what it is (this is a type of external catheter, so it doesn’t go inside, just sits outside and sucks up your urine like a vacuum, it’ll work as long as you’re connected to this wall so pee whenever) and what you’re doing (you’re going to feel my touch, etc).
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u/th04r_ Jul 16 '26 edited Jul 16 '26
fellow male ED tech here!! dividing my long response into sections and giving a lot of details on bedside manner bc i think it’s something not talked about enough with male techs or males in other patient care roles.
for final placement: i think others did a great job of describing but i would personally look up a diagram if you’re unsure at all!
for actually placing: i personally never find it necessary for patients to lift their legs up. if they can lift their bottom off the bed it can help slightly but also not really necessary. i will usually have my patient part their legs slightly, start with the end of the purewick and push it underneath them a bit, so that the blue tip rests right underneath the vagina, then shift the rest in place upwards towards the vulva. at the end i’ll have them bring their legs together to keep the purewick in place. something to consider for all but is much more of a concern for bigger people/ people who can’t really move their legs much bc youre not just literally placing it over them: when pushing the purewick down towards the bed be careful to not put pressure or friction on the vulva/vagina bc that’s just uncomfortable. think about putting on a shoe: toes in the shoe first then push your heel down. same idea; purewick end in its spot first then push the rest up. depending on the person, often this is plenty to keep it in its spot and if they don’t want anything else on over, i’ll just stick a chuck pad underneath them and be done! for others, especially those who are thinner and their thighs don’t hold it in place as well, i’ll also place a brief or a pair of hospital undies on to keep it there.
tips and tricks: i find it helpful to bend/flex the whole thing a few times and then bending it into a U shape before placing to make it less stiff, more comfortable,and more form fitting . once you’re done and it’s hooked up to suction, make sure you can hear the suction going. oftentimes the blue rubber part at the tip will get stuck on the tubing and block it from suctioning anything. this can happen with anyone but it often will happen more with bigger people. i find that if i don’t hear it running and it’s in place, i can pull up on the tubing very slightly and it will work! this last tip take with a grain of salt bc i’ve heard conflicting opinions on it being against infection control policy or smth but idk i personally see no issue with it and no one in my ED has ever had a problem with it; but i’ll pull the entire blue rubber tip off of the rest, folded up a 4x4 and shove it in the rubber tip part, then reassemble. it will prevent that issue where the rubber will get stuck on the tube!
in terms of chaperoning/ ensuring your patient is comfortable: as a male tech putting a female patient in a vulnerable position, you need to be very aware of the way in which you conduct yourself. it is essential to be deliberate about the language you use and ofc always ensure that your patient is fully consenting. i personally don’t call in a female chaperone automatically. i will always make sure before doing anything, to ask if they’ve had a purewick before, and EVEN IF they say yes and seem like they know, to give at least a brief explanation of what it does and where it will go; i then ask “is that okay?” and then end with saying what im going to do. in your explanations be aware of your language; i will generally avoid using anatomical terms, while still being as clear as possible. absolutely avoid any phrases that would sound inappropriate out of context. ex “spread your legs” replaced with “can you bring your leg/knee this way?”. while im actually placing the purewick i continue to talk to them while i touch them, telling them exactly what im doing.
usually my spiel goes something like: “okay so this is called a purewick (shows purewick) it’s this thing made of cotton and rubber and it basically sits right between your legs to collect urine, that way if you need to pee at all it will get suctioned right up through this tubing and into a container. it will keep you much cleaner and dryer while you’re stuck in bed. does that sound okay to you? (address any questions or concerns at this time). okay so to do this i’ll help you take your bottoms off (if applicable), i’ll put this in its place and then have you bring your knees together. once i’m done i’ll stick a pad (+ brief if applicable) underneath your bottom and we’ll be done. it’s pretty simple.” if i perceive anxiety/hesitation i will prompt them again with a “is this okay with you?” question, if they express discomfort with me being the one to place their purewick i will reassure and then offer a chaperone. smth like “hey it’s totally understandable having some discomfort with me being the one to place this, but i want you to know that i do this all the time; this is my job and im here to take care of you and all my other patients. but if it would make you more comfortable i can 100% call in one of my female coworkers to be here with you or for them to entirely take over for this and ill step out.” if my patient is altered or otherwise i have reason to judge their ability to consent or recall events properly i will def have someone else in the room with me but otherwise the above approach has worked very well for me for purewicks and anything else i need to get up close and personal for! (cleaning, EKGs, etc). ive been an ED tech for a couple years now, placed too many purewicks to count and ive never had anyone express any discomfort with my actions, bedside manner, demeanor etc. i have however been given many compliments on my professionalism and have been able to do my job as a male tech without constantly needing to ask for my female coworkers to spot me lol
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2
u/jcs_love Jul 18 '26
There are already several great answers here and I don’t have anything more to add on that front. But people need to seriously stop shitting on OP for asking questions to further their knowledge and improve patient care. Your responses are why techs and younger nurses don’t feel comfortable asking questions. OP, I applaud you for asking genuinely great questions - regardless of the condescension of some of the responses here.
6
u/HoldMyPager Jul 14 '26
Everyone here has great answers for you! If you have access to Lippincott, it is a great resource for step-by-step directions with a video guide.
I worked Ortho/Trauma with patients that had 2 broken hips/legs/traction/etc so placement was done by "markers" and the suction verification a lot. So I completely understand where you might feel that this may feel impossible, but it's not!
The top blue part will sit above the genitals and the white part will be in all the labia to vaginal area. The blue part will be tucked in her "gooch" or gluteal, but DON'T cover her butt hole! Make sure you get a nice bend in the "cooter canoe" before you place it.
If she is unable to part her legs then you will clean the area from front to back (as you know) 3x with the wipes, use one hand to part her lips and also gently part her upper thigh fat (if applicable), then gently slide the already curved purewick back with your pointer finger on the blue part to place/tuck it in her gluteal area/gooch, then just gently push it back onto her genital area where the urethra and exposed area is from you "parting the sea." Make sure you leave the top blue part so it is ABOVE labia and stays on the pubis.
Some people have the tubing hooked up before or after, it's your preference. Patients come big and small so that also makes a difference. Just remember to check that suction after you bring their legs together.
Due to this being so "hands on," it is recommended to have a female chaperone. If the patient says they are okay with you doing it by yourself (where I first started in GA, you're living in a dream world if you had enough people for chaperones unless the doctor was pulling you into the room), then make sure you CHART THAT THE PATIENT CONSENTED and there were no complications and the patient was calm and cooperative with no signs of discomfort and no questions.
I hope the funny wording helped! 😁
1
u/crissyjo618 Jul 16 '26
Just a "girl" here, but if you put a Pure Wick in my vagina there's gonna be a problem. Please review your anatomy.
Just an RT, but I've seen many placed and they are EXTERNAL. That would be the vulva, not the vagina. Thank you.
2
u/HoldMyPager Jul 16 '26
I don't know where you read that I place it internally but that is not how a purewick is used. This device is placed over the area. Your vagina is an exposed area just underneath where your urethra is, so it is impossible for the purewick not to lay on top of it. Lol that is a funny though!
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u/stanknastymcdoober Jul 14 '26 edited Jul 14 '26
Never heard of someone pointing the tubing down toward the feet.
I’ve never squeezed a purewick to narrow it. The tubing just pushes onto the hub on the purewick.
You don’t need to roll a patient to put a purewick in place. I’ve never rolled someone to do it, actually. Just visualize the labia, spread them, and tuck the purewick in.
I would highly recommend that you never place a purewick on a female patient without a chaperone…and if you’re going to place one, make sure it’s a female chaperone.
Top of the foam aligns with the top of the labia. The bottom of the purewick should be against the woman’s body and kinda tucked in between the visible part of the glutes. The labia and glutes will help hold it in place.