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anna liang
blistering under statlock

a BMT kid developed big blister under statlock. he scratched and pulled the line out. second picc was sutured in. removed sutures secondary to suspected skin local infection. now the line is secured/wrapped with gauze -- no tape because of blistering.

any recommendation re: how to secure the line

I have just been written up
I have just been written up by one of the nurse for recommending a dressing on that type of skin problem. This ICU nurse came to me a PICC nurse and asked what she should do on a dressing problem. Her gastric bypass patient had this massive edema that her skin was coming off, blistering, and weeping. The STATLOCK and the tegaderm could not  adhere anymore. I told her to use a sterile 4x4 then a tegaderm on top of it to provide some kind of protection, then wrap the whole arm in kerlig. She said it sounded good to her and turned around to report me for suggesting dressing change without a doctor order. I am thinking about changing the policy on dressing change, adding a section for PICC dressing for this type of skin issue. Does anybody have an example PICC dressing of this special skin problem? Thanks in advance.
first, is the skin being

first, is the skin being prepped with skin protectant prior to application of the Stat-Lock?  Some people use tincture of benzoin but in my work with oncology and espescially kids, this is very irritating.  3m has a no-sting barrier that I used on my peds onc patients with very good success. 

Also, removal of the device with dressing changes and use alcohol to remove them. 

If it is still a problem with this, then you may want to check out the new Centurion device for securement.

Laurie Rasberry, RN, BS, CRNI, OCN

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