Catheters

[alrightstill]

Betadine makes me extremely itchy, so I've been using alcohol swabs... Should I inquire about using something else? 


I have to go for a cathetergram on Friday.    Been having extremely bad spasms and high arterial pressures.  Whenever I used to go for a cathetergram, the doc would always try and talk me into getting another cath put in.. "Oh, it's quick!  We can do it right now!"  I don't want another one tho, wahhhh! < / end rant >

[DeLana]

Actually betadine is what most catheter manufactures recommend to clean their catheters.  It doesn't matter what the preference of the clinics or patients is it matters what the manufacturer says.  There are some that it is recommended to use except or alcavis, but very few. 

Maybe the manufacturers need to reconsider their recommendations - the CDC has found that some bacteria grow quite well in Betadine (if used incorrectly*), this is the reason why our clinics stopped using it; chlorhexidine on the other hand kills pathogens on contact.  However, I do understand that the alternatives can probably damage some catheters, so it's a real dilemma.  With the intended short-term use of perm caths this would not be such a big problem, but we see a lot short term CVCs that become long term... different topic, though.

DeLana

*If workers don't soaked the cath extensions long enough or let the Betadine dry before applying the dsg (or, for that matter, let the peripheral access site dry before cannulation).

[DeLana]

Betadine makes me extremely itchy, so I've been using alcohol swabs... Should I inquire about using something else? 


I have to go for a cathetergram on Friday.    Been having extremely bad spasms and high arterial pressures.  Whenever I used to go for a cathetergram, the doc would always try and talk me into getting another cath put in.. "Oh, it's quick!  We can do it right now!"  I don't want another one tho, wahhhh! < / end rant >

I had a patient whose access was a permanent Tesio - she refused to be considered for another graft (the leg would have been the only site left, she has been on dialsyis for 25 years and is doing very well*).  She could not tolerate anything but alcohol swabs on her access site - and in the 5 years I worked with her, she had one catheter infection.  So that's very good.  You should be fine, but perhaps they have chlorhexidine, you could certainly ask.

Are you getting adequate Qb (blood flow) and clearance (Kt/V)?  If so, you may be fine if you have your current Tesio revised.  Anytime a new cath is placed, there is a chance of vessel damage and additional scarring, and of course no guarantee that it will work well.  You could ask your surgeon about these risks (he should have already explained them to you), and perhaps get a second opinion - I do realize that's not always a realistic option.

Good luck tomorrow, let us know how it went.

DeLana

*She chooses not to pursue a transplant, and her underlying disease - an extremely aggressive glomerulonephritis that caused ESDR within a few weeks of onset of symptoms - may not make this a good choice anyway.

[CVCclean]

Essentially there are few catheter materials on the market today: silicone and polyurethane (carbothane and tecoflex-TM) It is imperative for the handler to determine if the antiseptic/disinfectant is compatible with these catheter products.  Using an incorrect solution on a hemo or peritoneal catheter can lead to catheter degredation and possibly breaking of the catheter, which can cause serious infection.   Povidone iodine and chlorhexidine with alcohol are contrindicated with some catheter materials.  ExSept Plus and Alcavis 50 (ALCAVIS INTERNATIONAL) are effecient and have excellent material compatibility.  These products cannot become contaminated in the bottle and are cents per application.  Also, it kills microorganisms in 60 seconds.  It saves staff time,(2 minutes) vs. povidone iodine application. (3-5 minutes)
I am a dialysis RN with 24 years of experience in the renal field.  When used per procedure, these products decrease the risk of catheter-related blood and exit site infections.   Reply if you would like to know more.  A team approach is what it takes to stay well!  Your staff will listen.

[Sluff]

Essentially there are few catheter materials on the market today: silicone and polyurethane (carbothane and tecoflex-TM) It is imperative for the handler to determine if the antiseptic/disinfectant is compatible with these catheter products.  Using an incorrect solution on a hemo or peritoneal catheter can lead to catheter degredation and possibly breaking of the catheter, which can cause serious infection.   Povidone iodine and chlorhexidine with alcohol are contrindicated with some catheter materials.  ExSept Plus and Alcavis 50 (ALCAVIS INTERNATIONAL) are effecient and have excellent material compatibility.  These products cannot become contaminated in the bottle and are cents per application.  Also, it kills microorganisms in 60 seconds.  It saves staff time,(2 minutes) vs. povidone iodine application. (3-5 minutes)
I am a dialysis RN with 24 years of experience in the renal field.  When used per procedure, these products decrease the risk of catheter-related blood and exit site infections.   Reply if you would like to know more.  A team approach is what it takes to stay well!  Your staff will listen.

It's great to have you here at IHD CVCclean, we appreaciate your perspective. I would invite you to post in the Introduce yourself section so we can get to know you better.

Thanks

Sluff, Moderator