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Kristine Selck
Ethanol Locks

Does anyone have a policy/procedure for ethanol locks in CVLs they are willing to share?  I have the Nebraska Medical Center procedure. Looking for more information as we develop our own procedure.  Also, I am finding lots of conflicting data on polyurethane catheters, what is the current thinking on the use of ethanol in these?  Do we need to just contact each manufacturer individually?

Thank you for any and all responses,

Kristi Selck, RN

Clinical and Evidence Based Practice Council Chair

Shands Hospital at UF

lynncrni
 You should contact each

 You should contact each catheter manufacturer whose devices are made of polyurethane to see what information they will provide. As far as I know, no polyurethane catheter includes instructions about using ethanol as a lock solution inside the catheter. So if you choose to do it, this practice would be off-label use. Alcohol acts as a solvent on polyurethane. Isopropyl alcohol would be worse than ethanol. Also, there are at least 3 different formulations of polyurethane currently being used. The older formulations have a greater issue with alcohols than the newer formulations. Please let us know if you find any catheter manufacturer that now includes ethanol locks as an acceptable practice for their catheters. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

kradicia
Ethanol Locks

Hi Kristi,

Just curious on how and when you obtained the policy from TNMC. Please look at the date on the policy. I advise on this at TNMC and we do not encourage the use of ethanol in Central Venous Devices.

Kathy Radicia, RN

Vascular Access Specialist

The Nebraska Medical Center                                                                                                                                         

Omaha, NE

lynncrni
 I found the Nebraska Medical

 I found the Nebraska Medical Center policy on ethanol locks online a couple of years ago. It is a well-written policy and I have shared it in multiple presentations. Lynn

 

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Karen Rankin
Ethanol

I have used the Nebraska document and other published data to develop our protocols for using Ethanol in central lines (in children) - we have been successfully using it on our home PN patients (not all) with fantastic success - is this now a major problem given the comment from Kathy.

Karen Rankin

Clinical Nurse Consultant

the Children's Hospital at Westmead - Australia

brooklynn21
Ethanol lock policy

I also have had great success with ethanol locks in PN patients as a means to salvage the line or reduce infection rates in those individuals that continually have central line infections.  I have written a policy for our home care patients that I would be willing to share.  Please send me your e-mail address and I will forward it to you.

Brooke Thompson

Random VAT person
Is Ethanol simular to alcohol?

Bard states that continous alcohol breaks down the polyurethane caths over time.   Is Ethanol simular to alcohol and could it cause the same issue?

 

thanks

David

 

lynncrni
 Ethanol is the form of

 Ethanol is the form of alcohol that you can ingest and infuse. It is infused to treat several conditions. Isopropyl alcohol is the same as rubbing alcohol and what we use in alcohol pads. Both of these are forms of alcohol. You would want to get further clarification from the manufacturer on what type of alcohol they are referring to. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

pfintonis
if I may add a related

if I may add a related question;  A patient with a implanted VAD/Port presented to the E.D. with instructions from her doctor to get blood cultures via her port. She uses ethanol locks for the port at home, and it was dwelling in the accessed VAD at the time of presentation. Normally for cultures drawn from a CVAD, we do not waste as recommended, but what will the effect of the ethanol have on the culture. Should we waste in this instance?

lynncrni
 Since the ethanol could

 Since the ethanol could easily alter the outcome of this culture, I would draw and waste at least 3 times the internal volume of the entire system, then draw the culture. I have never seen any data on this, so we are making this decision on basic common sense at this point. Lynn

 

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

brooklynn21
Ethanol lock supply

I work for a home infusion company and we have been unable to obtain the 98% ethanol.  Does anyone have any sources for obtaining this?

Thanks, Brooke

Brooke Thompson

lynncrni
 You can only about it from a

 You can only about it from a compounding pharmacy. There are no commercially available alternative lock solutions in the USA. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

brooklynn21
Compounding pharmacy

Yes, we are a compounding pharmacy but unable to find the 98% ethanol to compound.

Thanks, Brooke

Brooke Thompson

BeeDee
100% ethanol

 Brooke, Not sure if you are allowed to  access alcohol outside the USA but back in 2002 my 100% ethanol  came from

DBL [David Bull  Laboratories, Australia]

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