Wondering how long other institutions hold pressure to the exit site when removing renal and also femoral lines. What do you consider an occlusive dressing? We use a sterile vaseline gauze, covered with a sterile 4x4 (folded) then covered with foam tape as a pressure dressing for 24 hours. Other areas consider a Tegaderm as an occlusive dressing although it is semipermeable. Appreciate any replies.
I have had several recent conversations about what actually constitutes an occlusive dressing. The medical dictionary at Medline Plus has a definition of occlusive dressing- a dressing that seals a wound to protect against infection. http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=occlusi...
This does not speak to air passage, pressure for hemostasis, or being totally adherent on all sides.
I am assuming that you are asking about venous lines and not arterial, right? I would also think that the size of catheter being removed is an important factor as a larger catheter will leave a larger hole.
I would consider your dressing, a transparent membrane dressing, and a regular tape and gauze dressing to be an occlusive dressing. Since the femoral site is below the level of the heart, air emboli is a lower risk, but it could still happen. I am in the middle of searching the literature now on air emboli and am surprised at the number of surgeries, treatment and diagnostic procedures plus pregnancy where AE can occur. To prevent AE when a catheter is removed, the standard is to add an ointment to the site to provide adequate sealing of the site. So if prevention of AE is the goal, you are accomplishing that with the vaseline gauze. 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