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Michelle Todd CRNI
PICC/CVC removal vaseline versus iodine ointment to seal the hole

 We have always used iodine ointment on our sites with line removal unless the patient is allergic, then we use vaseline. I am wondering if we should be using vaseline on everyone because it seems like the iodine ointment actually absorbs into the gauze and it would seem that this would then fail to provide the desired protection from delayed air embolism. What is everyone using? I have also heard of vaseline gauze but this seems like a much more expensive alternative that  would do the same thing as cheap vaseline and 2x2 with transparent dressing for 48 hours.

lynncrni
You do not need an antiseptic

You do not need an antiseptic or antimicrobial ointment to seal the site of any CVC upon removal, but you do need some type of petroleum-based ointment. Many have stopped using povidone-iodine and triple antibiotic ointment because it is considered to be a medication with all the requirements that entails. So any type of petroleum based ointment will work find, such as Vaseline gauze. The goal is not infection prevention, but rather to seal the hole. I would have reservations about using a jar of Vaseline that is used on multiple patients as this could become contaminated. 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

daylily
The Journal of Infusion

The Journal of Infusion Nursing had instructions for the removal of central venous catheters (including PICCs).  I believe it was under the legally speaking section and stated antiseptic ointment.

lynncrni
That was based on the 2006

That was based on the 2006 standards. The 2011 standards will be out in Jan 2011 with revised language. As noted in my earlier message, the antiseptic part is not the goal with any CVC removal. The petroleum base is the important part. Lynnv

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

Michelle Todd CRNI
  I understand the idea is to

 

I understand the idea is to seal the hole, however, we had been under the impression that the betadine ointment would do this. I am not sure that it does because it seems to soak into the gauze and not really be greesy and a true seal. Thanks for your clarification where I think you are saying that indeed it does not seal. And in addition, it is a medication which would need a standing order. Is that correct? It does not really seal?

The vaseline that we use is a single unit dose pouch and a new one is used for PICC removal. We do not have any jars of it for any use. Do you feel that using the vaseline and gauze and tegaderm is just as adequate as the more expensive vaseline gauze? I would assume it is but I have not used the vaseline gauze so I wanted to get your thoughts.

 

 

lynncrni
A jar of vaseline used for

A jar of vaseline used for multiple patients can easily be colonized and become the source of infection shared among all patients. Use a single package of vaseline gauze instead. 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

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