We are presently using ethanol locks for select high CLABSI risk clients, with a dwell time of 24 hours. We now have a client that I'd like to leave the ethanol in for 48 h but am having difficulty finding literature describing a longer than 24 h dwell. If anyone has information or experience in this can you kindly contact me or reply on this forum?
Daphne Broadhurst RN
Desjardins Pharmacy
Ottawa ON
dbroadhurst[at]oms[dot]ca
1.613.244.4560 x 2383
This website will get you to a pdf with a very detailed protocol for Ethanol locking:
http://www.nebraskamed.com/App_Files/pdf/careers/education/asp/TNMC_EtOH...
Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Is it necessary to remove the ethanol after the dwell time or can it just be flushed through. The doctor said to remove it and the pediatric nurse said to flush it through. This is for a 2 year old who is on TPN.
Michelle Todd, CRNI--Head PICC Nurse, Vibra Specialty Hospital of Portland [email protected]
What ethanol concentration and what volume? For a 2 year old, a high concentration and a large volume could cause some side effects typical of ethanol infusion. Most protocols call for flushing it into the bloodstream for adults, but I have never seen any specific peds studies on this issue. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thanks for the links
Michelle Todd, CRNI--Head PICC Nurse, Vibra Specialty Hospital of Portland [email protected]
3 articles that may be of interest for you in peds with ELT are:
Jones, B. A., Hull, M.A., Richardson, D. S. et al. (2010) Efficacy of ethanol locks in reducing central venous catheter infection in pediatric patients with intestinal failure. J of Peds Surgery. 45 1287-1293
Mouw E., Chessman, K., Lesher, A., and Tagge, D. (2008). Use of an ethanol lock to prevent catheter-related infection in children with short bowel syndrome. J of Peds Surgery. 43 1025-1029.
Onland, W., Shin, K. and Fustar, S.(2006). Ethanol lock therapy for persistent bacteremia for long term intravascular devices in pediatric patients. Archives of Pediatric and Adolescent Medicine, 160, 1049-1053
Linda Tirabassi PhD RN CNS CPNP
Daphne--What is the pharm name of the locking solution that was approved for wide use in Cananda in the past couple of years?
Robbin George RN VA-BC
I can not recall their brand name but it is made by Excelsior Medical and is 30% ethanol and 4% citrate. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Robbin, "Citranol" is the name of the ethanol 30%, citrate 4% prefilled syringe, manufactured by Excelsior Medical, that has just come onto the Canadian market this spring. Can't wait to see the outcomes of a product that kills bugs and keeps the catheter patent. Meeting with the rep next week to have a closer look.
Daphne Broadhurst
Desjardins Pharmacy
Ottawa, Canada
I think you have done a good work keep it up buddy wish you best of luck!
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