After having one PICC in for 5 months with a Sorbaview dressing, alcohol and betadine prep and no sking rash, and then the second PICC line in for 5 months using Chloraprep, and Sorbaview and a tremendous skin rash. I would say it is a cumulative effect. They only difference was the Chloraprep in my case. All preps were allowed to dry thoroughly each time. Thank goodness for ports!
Patty Luptak
Director of Oncology
Jefferson Regional Medical Center
Pittsburgh, PA
Dianne Sim <[EMAIL PROTECTED]> wrote:
Dianne Sim <[EMAIL PROTECTED]> wrote:
Considering that your nurses are performing the dressing technique
appropriately and allowing the skin antiseptic to dry before applying the
dressing, I would suggest that the patient may have developed a cumulative
sensitivity to the adhesive on the dressing. Some patients who are sensitive
to Tegaderm are not to Opsite or Sorbaview, or vice versa. After settling
the site down with change of skin antiseptic and a significant period with
gauze dressings, I would trial another occlusive dressing. In our experience
the Sorbaview dressing seems to be the least irritating. Also make sure the
nurses are using a skin protectant.
Good Luck.
Regards,
Dianne Sim
IV Assist, Inc
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Alma Kooistra
Sent: Wednesday, April 12, 2006 4:12 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
>
>
>
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Patty ![]()
Patty Luptak RN OCN BSEd
Manager Oncology/Infusion Services @ Jefferson Regional Medical Center
LITE Presidential Advisor
www.lite.org
Manager Oncology/Infusion Services @ Jefferson Regional Medical Center
LITE Presidential Advisor
www.lite.org
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