It is surprising how long a minute REALLY is, vs. what 'seems' like a minute to us!! Good point about actually watching the clock Chris!
Ann Ann Williams RN CRNI Infusion Specialist Deaconess Home Services 600 Mary St. Evansville, IN 47747 812-450-3828 812-450-4665 FAX -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Chris Cavanaugh Sent: Wednesday, April 12, 2006 9:35 AM To: [EMAIL PROTECTED] Subject: RE: site rash I have seen the same thing in both hospital and LTC patients. When I discussed this with the ChloraPrep rep, she told me letting the Chloroprep dry was the key. Sure enough, allowed longer drying time (a full 45-60 seconds, watching a clock) and using a site prep like the one from 3M cleared up the problems. The site prep is very important for elderly who's skin is more sensitive both to the Chloroprep and the adhesives in the opsite or Tegaderm. Often, nurses think they are letting it dry, but putting on a TSM dressing in 15-20 seconds of the end of the scrub.... Chris Cavanaugh, CRNI -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ann Williams Sent: Wednesday, April 12, 2006 9:34 AM To: Alma Kooistra; [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: RE: site rash We use Chloraprep & Opsite IV 3000 and have rare skin reactions. When we used to use Tegaderm we had more complaints. After starting the use of Chloraprep 3 years ago, we had a few of these reactions like you describe, and I questioned here about it. The answer I got, and I passed on to the field nurses, was to let the chloraprep dry longer than the 30 seconds the company suggests. (around 1 minute seems good) This has worked for us. Maybe you can just drop the 1 minute idea to the nurses, to them "allowing it to dry" could just be the 30 second company recommendation. Good luck! Ann Williams RN CRNI Infusion Specialist Deaconess Home Services 600 Mary St. Evansville, IN 47747 812-450-3828 812-450-4665 FAX -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Alma Kooistra Sent: Wednesday, April 12, 2006 6:12 AM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Re: site rash We have had these same reactions, most also among our home infusion patients. We also got the 'contact dermatitis' diagnosis that just didn't seem to me was a good fit. I addressed the issue with the staff caring for these lines and they insisted that they were not stretching the tegaderm and that they were allowing the skin to completely dry. One of out patients completed his cycle of abx and later when he needed a new PICC he had the same skin reaction. Which prompts the question......what alternative cleanser/dressing do you use in a case like this? With our patient, we eliminated the StatLock, switched to alcohol/betadine cleansing, and went to a gauze dressing. Things got some better, but the line was removed due to completion of tx before everything completely cleared up. Any other/better ideas????? Alma Kooistra RN, CRNI ----Original Message Follows---- From: "Gwen Irwin" <[EMAIL PROTECTED]> To: [EMAIL PROTECTED] Subject: Re: site rash Date: Tue, 11 Apr 2006 21:31:39 -0500 Since your description leads me to believe the size of this reaction is exactly the size of the dressing, I probably would also think of contact dermatitis. We have responded to these type of situations in our network and had resolution of the occurrence by allowing the prep to dry. Our experience with this kind of "reaction" has been the prep isn't dry or the transparent dressing has been "stretched" over the insertion site when placed over the site. I will be interested in what others have to say they have experienced, since I haven't seen anyone react to the CHG alone. Not to say that it couldn't happen. Gwen Irwin Austin, Texas ----- Original Message ----- From: "Maria Kostylo" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Tuesday, April 11, 2006 8:09 PM Subject: site rash >Hi All, > >We're seeing patients in our SNF unit that develop rashes under their >PICC site dressings weeks and/or months after it's been inserted. Our >ID nurse is sure it's contact dermatitis. We do weekly (and prn) >dressing changes using Chloraprep, Biopatch and TSM. It is the IV >therapists doing the dressing changes, and they assure me the prep is >completely dry before they apply the dressings. Do you think the >patients just develop a cumulative sensitivity to CHG? I know some of >my nurses have had to switch to a different soap because they're >developing skin irritations r/t frequent handwashing with CHG. > >Thanks, Maria > > > >Confidentiality Notice: This e-mail message, including any >attachments, is for the sole use of the intended recipient(s) and may >contain confidential and privileged information. Any unauthorized >review, use, disclosure or distribution is prohibited. If you are not >the intended recipient, please contact the sender by reply e-mail and >destroy all copies of the original message. > ------------------------------------------------------------------------ ---- ---------------------------------------- This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the originator of the message. 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