RE: culture protocols/guidelines for suspected CRBSI

[Ward Gina]

What about when the site looks bad?  You dont see any signs of CRBSI but worried about the potential because the site looks poor.    Do you follow that same protocol.   We have had several patients from home ( outpatients for daily antibiotics ) who  we struggle with keeping the dressing clean and dry ( we wrap around them with kling and fluff)  ( have done more frequent dressing changes  to maintain a good clean site)  they get really red under the opsite and have even had white patches under the biopatch?  ( you would think it would be beyond the biopatch) we have also tried using chlora prep to clean instead of alcohlo and betadine )    Anyway........  When we ultimately remove this picc should we do cultures on the tip?  Blood cultures peripheral as well as picc line??     I dont see that in any of the CDC guidelines?   It all starts with a suspected CRBSI.   Thanks  in advance!   Gina Ward R.N., C.P. A.N. From: [EMAIL PROTECTED] on behalf of Kokotis, Kathy Sent: Mon 8/14/2006 12:35 PM To: Elizabeth Harmon; [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: RE: culture protocols/guidelines for suspected CRBSI The protocols are right in the CDC guidelines on an algorithm or in Mermel's article that Hadaway sent out   www.cdc.gov Intravascular guidelines in 2002   kathy       Confidentiality Notice:  This e-mail and any attachments are intended only for the use of those to whom it is addressed and may contain information that is confidential and prohibited from further disclosure under law. If you have received this e-mail in error, its review, use, retention and/or distribution is strictly prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message and any attachments.[v1.0] From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Elizabeth Harmon Sent: Saturday, August 12, 2006 9:29 PM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: culture protocols/guidelines for suspected CRBSI Does anyone out there have anyestablished protocols/procedures or guidelines their facility uses when Central Lines are removed for suspected CRBSI?  Would you be willing to share?  If so please e-mail me privately.  We are working on a set protocol for all Physicians to follow for any suspected CRBSI.  It would be done anytime a central line is changed or pulled and another one is placed.  Previously lines would get pulled, no cultures, nothing and meds changed, and the lines blamed for the problem.  We are looking to have set protocols.   Thanks in advance.   Betsy Harmon RN CRNI Vascular Access Team Critical Care Unit Alaska Native Medical Center Anchorage, Alaska [EMAIL PROTECTED]