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I forwarded this to the listserv because I think a lot
of you would be interested in it. I also want to thank everyone for their
responses to my inquiry. You've been very helpful.
Jerry Bartholomew RN BSN
CRNI From: Helen lazeration [mailto:[EMAIL PROTECTED] Sent: Friday, December 23, 2005 7:18 PM To: Bartholomew , Jerry A (SPO) Subject: Re: Hickman line and skin sensitivity Jerry,
A couple of things - After about 6 weeks we leave the
dressings off most of our cuffed central lines. We do secure the tubing
with a small tubing holder. Occassionally we leave the dressings on such
as in our immune compromised patients.
Our infection control doc here once time had me try Azmacort
Inhaler Spray on several patients that had irritated skin from dressings for one
reason or another. It is an approved use and it is great for two reasons -
we used to have to go to gauze dressings because we used a hydrocortisone cream
and the dressing were messy. With the azmacort we leave the dressing prep
off of the skin after we clean it and spray the azmacort spray on, let it dry -
it leaves a white film - then apply whatever dressing we use (currently Tegaderm
IV) and the rashes clear up easily, if not better than with the creams. I
couldn't believe the first few times we tried it - our WOCN nurse now uses it
under some of her wound care appliances also. It may help your patient if
the doc is willing to try it
On occasion we have also gone to cleansing the skin of really
sensitive patients with baby shampoo - doing a 2 minute scrub instead of the
regular cleaners in the dressing kits etc. I know that this sound not very
aseptic, but it works and is the current accepted scrub used on a lot of serious
burn patients by our plastic guys and it helps with any sensitivities to all of
the products we would normally use on our patients. Our line infection at
our hospital is less than 1%.
Hope this helps.
Helen Lazeration, CRNI
Fairbanks Memorial Hospital
Fairbanks, Alaska
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Title: Hickman line and skin sensitivity
