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]
hi.org>
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
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