We used to always use iodine ointment (other type of ointment if allergic) with removal of a CVC line to "seal the hole" and prevent air embolism. But I have heard that some hospitals only use gauze and tape. Some used gauze and tegaderm. Some use antibiotic ointment. What is everyone doing now and what is recommended by CDC or INS. I have been unable to find this information.
Please note that the CDC does not make a statement about this practice because it is not for the purposes of infection control. It is for the purposes of sealing the skin-to-vein tract that remains when you remove a CVC. This tract can remain open and pull air into the bloodstream. INS standards definitely recommend this practice, See page S52-54, Standard 49 Catheter Removal.
I have served as the expert in 2 legal cases where this was a critical issue. You also need to have documented competency for all nurses removing these lines, and this includes the proper dressing upon removal and the use of ointments to seal this site.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
multi-ply petrolatum gauze + sterile gauze topped with tegaderm.
Mari Cordes, BS RN
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
We also are looking at this. Unfortunately we don't have sterile petroleum jelly or betadine ointment in our community inventory. I'd like your thoughts on using sterile lubricant jelly (water-based). Being water-based would it occlude the site? Alternatively, is there any way a sterile transparent film dressing be sufficient as it is apparently occlusive to air/fluid from the external surface??
Thanks,
Daphne Broadhurst
Desjardins Pharmacy
Ottawa, Canada
Daphne Broadhurst
Desjardins Pharmacy
Ottawa, Canada
No, a transparent dressing alone will not provide the occlusion that is needed. This was an issue in one of my legal cases. The petroleum based ointment is required to adequately seal the site. This is done with an antiseptic ointment added to a gauze dressing or a Vaseline-based gauze dressing. You can then cover this with a transparent dressing or tape.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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