RE: Hickman line and skin sensitivity

[Bartholomew , Jerry A (SPO)]

Title: Hickman line and skin sensitivity

I will check in to the Coverderm dressing.  Another item we are considering is the Ray-Marshall LineGuard Shield, a small circular dressing which I am told they use routinely for central lines in burn patients.

 

Jerry Bartholomew RN BSN CRNI
Vascular Access Specialist
Veterans Affairs Medical Center
Spokane, Washington

 

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From: Mazza, Kathleen [mailto:[EMAIL PROTECTED]
Sent: Thursday, December 22, 2005 9:14 AM
To: Debbie Potts; Bartholomew , Jerry A (SPO); [EMAIL PROTECTED]
Subject: RE: Hickman line and skin sensitivity

I had a patient with similar history (even was also a nurse.. interesting....) - She did well with Coverderm dressing - It was the only one she could tolerate. As for Hickmans, I have had several patients who had long term catheters who stopped using dressings (once the catheter site was well healed) without problems. One patient I know has had the same Hickman for 6 or 7 years for TPN without infection and without sterile dressings. She does clean the site - just doesn't dress it.

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Debbie Potts
Sent: Thursday, December 22, 2005 11:10 AM
To: Bartholomew , Jerry A (SPO); [EMAIL PROTECTED]
Subject: RE: Hickman line and skin sensitivity

Hve you tried Covaderm?  We have the same problem with some of our oncology pts' and when we run the gamet of TSM we usually go to a gauze dressing and they do quite well.  Of course you then have to change q 48-if a pt. has had a line for some time we have done 3xwk and they do well.

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From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Bartholomew , Jerry A (SPO)
Sent: Thursday, December 22, 2005 10:42 AM
To: [EMAIL PROTECTED]
Subject: Hickman line and skin sensitivity

        I have a young nurse as a patient who, after three PICC line placements, now has a Hickman line.  We had requested an implanted port, but they decided on the Hickman because she suffers from chronic folliculitis.  She is extremely sensitive to everything.  Every type of hypoallergenic dressing has been tried, including the IV3000, Sorbaview 2000, Duoderm, Hypafix tape, you name it.  We are currently using the IV3000, which did well for the first three weeks, but now the skin beneath it is becoming reddened, and burns when cleaned with alcohol. 

        Since this is a cuffed, tunneled line, I am wondering whether or not it might be better in her case to leave the site open to air.  She is an outpatient, so she's not around the constellation of killer pathogens that inpatients face.  Has anyone else done this?

Jerry Bartholomew RN BSN CRNI
Vascular Access Specialist
Veterans Affairs Medical Center
Spokane, Washington

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