Course Access
Hi Fiona and Michael,
to my knowledge there is no trial to prove this one way or the other.
Given this is a hole in the skin and the blood vessel, and removal of the device may irritate the local skin thus stirring up the resident microorganisms, I would think it justified to use some form of antiseptic to clean the site prior to removal.
Particularly since this is a quick and low cost intervention, and there is commonly dried blood or moisture at the site which may potentially eight infection risk if not removed.
It’s likely then going to sit under a plastic dressing for a few days, so it would be nice to know that the microbial load had been reduced prior to applying that.
As always-important to let the antiseptic dry 1st to let it work, as well as to avoid all of the “allergies” that people blame on the dressings, which are probably more often caused by a non-dry antiseptic.
Given the device is coming out, it could be argued that 70% alcohol would be adequate (potentially we don’t need the ongoing effect of chlorhexidine), but for the sake of consistency and feasibility of what is on the shelf et cetera, probably I’d go with the chlorhexidine and alcohol.
That’s my opinion based five cents anyway, Claire
Kind regards,
Dr Claire Rickard RN PhD FAHMS FACN
Director, Alliance for Vascular Access Teaching and Research
Menzies Health Institute Queensland
and
Professor of Nursing, School of Nursing and Midwifery
Griffith University, Australia
P.S. This email may have been dictated, please excuse any errors.
Hi Fiona
Thanks for asking this, has created a discussion here!
Our policy does not specify whether to clean the skin prior to sheath removal with any agent, but on talking to our critical care staff there is quite a bit of variation in actual practice.
* Some treat as an IV access procedure, and use 2% chlorhexidine and alcohol prior to removal;
* Some cleanse with normal saline prior to removal;
* Some just wipe the skin with gauze if there is blood or fluid at the site prior to removal.
Can’t see anything glaringly obvious in a number of cath lab sheath removal protocols from around the world from a quick google search, so it might be something there is not much data on.
Will ask the vascular access researchers at AVATAR to see if they have any data to inform this.
Cheers
Michael
Michael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au
[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]
Hi All,
We are currently reviewing our protocols for the removal of arterial and venous sheaths, and are having discussions regarding the site being cleaned prior to removal. I am interested if other facilities undertake a skin prep / cleanse prior to removal and if you do what products do you use?
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control
IPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
________________________________
CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return https://clicktime.symantec.com/36JsQxC23zPnvkQSL4NDBnA7Vc?uemail%2C%20delete%20the%20Email%2C%20and%20do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au
To send a message to the list administrator send an email to admin@acipc.org.au
You can unsubscribe manually from this list by sending ‘signoff acipclist’ (without the quotes) to listserv@aicalist.org.au
______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au
To send a message to the list administrator send an email to admin@acipc.org.au
You can unsubscribe manually from this list by sending ‘signoff acipclist’ (without the quotes) to listserv@aicalist.org.au
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au
To send a message to the list administrator send an email to admin@acipc.org.au
You can unsubscribe manually from this list by sending ‘signoff acipclist’ (without the quotes) to listserv@aicalist.org.au