There is some reason to be concerned about the use of alcohol on
some polyurethane catheters. However the manufacturers recommendations
may or may not be based on actual or simulated product use in the real
clinical world. Toward that end, Dr. Maki has conducted a bench test
on catheter made of Pellathane, a second generation of polyurethane,
applying alcohol to these catheters for at least 9 weeks. His
published work states they found not changes to this brand of
polyurethane.
There are catheters made of older types of polyurethane that
could have a problem with alcohol and there are newer catheters of
newer types of polyurethane that are more compatible with
alcohol.
The issue is weighing the risk of frequent catheter removal and
reinsertion for catheter-related bloodstream infections in long-term
patients versus the benefits of resolving the issue with an ethanol
lock. Here is the reference for Dr. Maki's work:
1. Crnich
C, Halfmann J, Crone W, Maki D. The effects of prolonged ethanol
exposure on the mechanical properties of polyurethane and silicone
catheters used for intravenous access. Infect Control Hosp Epidemiol.
2005;26(8):708-714.
This is not an easy decision.
Lynn
At 9:21 AM -0600 6/9/06, Blackburn, Paul wrote:
I always get a little concerned when I hear people speaking about ethanol locks. Ethanol locks take meticulous care, which can not be guaranteed once the PICC passes out of the vascular access nurses' control. There are many factors to consider when locking a PICC with ethanol. First and foremost is the material the PICC is made of. Can this material tolerate continuous exposure to ethanol? Considering the variety of polyurethanes that exist out there, it may be difficult to get a definitive answer for that question--so does that mean you can only use ethanol locks on silicone PICCs? If that is true, how easy is it to distinguish between a polyurethane and a silicone PICC? Next, and probably even more important, how much ethanol should be used to lock the PICC? This will vary for each PICC, depending upon the PICCs' lumen size, the overall length of the PICC and any add-on devices that may be directly attached to the PICC. Again, a difficult number to pin down as this will vary from manufacturer to manufacturer. All in all, ethanol locks, in my mind, are risky. Paul
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Paul L. Blackburn, RN, MNA
Manager, Clinical Education
Office: 800-443-5505, ext. 4981
Mobile: 801-598-1657
Email: [EMAIL PROTECTED]
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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
