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Correct technique for skin asepsis prior to blood culture taking

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  • #70485
    Liz Orr
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    Liz Orr

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    Hi all,

    We are working on a protocol for taking blood cultures. I had a question regarding technique for the skin prep. Should we be using concentric circles or a rubbing action backwards and forwards? We are using 2% chlorhexidine 70% alcohol for the skin prep. Does anyone have any references or evidence as to which option is best practice?

    Regards,
    Liz Orr
    Infection Control Consultant
    Monash Health
    Monash Medical Centre Clayton
    9594 2623
    liz.orr@monashhealth.org

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    #70486
    Matthias Maiwald (KKH)
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    Matthias Maiwald (KKH)

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    Dear Liz,

    From my reading, it seems like there is no right or wrong to your question, and I have seen both techniques described in the literature, although I don’t think this has been propertly (scientifically) investigated. It is more common to see the circles method described. One manufacturer of 2% CHX 70% IPA applicators seems to recommend back and forth with their applicators.

    From a microbiological perspective, what is more important is (a) repeated applications with fresh antiseptic and (b) a sufficient contact time for the antiseptic to act and kill skin microorganisms. But there are no good published data on how many and how long. It seems that at least 2 subsequent applications are necessary, and at least 1 min overall contact time for blood cultures. (Note, at least). We are talking blood culture collection, which is biologically/physiologically different from other applications of skin antisepsis.

    Best regards, Matthias.


    Matthias Maiwald, MD, FRCPA
    Consultant in Microbiology
    Adj. Assoc. Prof., Natl. Univ. Singapore
    Department of Pathology and Laboratory Medicine
    KK Women’s and Children’s Hospital
    100 Bukit Timah Road
    Singapore 229899
    Tel. +65 6394 8725 (Office)
    Tel. +65 6394 1389 (Laboratory)
    Fax +65 6394 1387

    Hi all,

    We are working on a protocol for taking blood cultures. I had a question regarding technique for the skin prep. Should we be using concentric circles or a rubbing action backwards and forwards? We are using 2% chlorhexidine 70% alcohol for the skin prep. Does anyone have any references or evidence as to which option is best practice?

    Regards,
    Liz Orr
    Infection Control Consultant
    Monash Health
    Monash Medical Centre Clayton
    9594 2623
    liz.orr@monashhealth.org

    ________________________________
    THIS E-MAIL IS CONFIDENTIAL. If you have received this e-mail in error, please notify us by return e-mail and delete the document. If you are not the intended recipient you are hereby notified that any disclosure, copying, distribution or taking any action in reliance on the contents of this information is strictly prohibited and may be unlawful. Southern Health are not liable for the proper and complete transmission of the information contained in this communication or for any delay in its receipt.
    ________________________________
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