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netty10453
prepping for picc insertion
I was looking at the Gallery photos and was wondering what everyone else's practice is in the prepping stage of picc insertion.  We use full barrier drape and wear a gown ourselves when we prep the patient.  This picture shows a nurse without a gown and no sterile barrier on the patient.  Is this common practice?  Thanks
monicasorg
I looked at the photos in
I looked at the photos in the gallery.  From what I can see, the patient is draped....can't see the patient's head and foot, so I'm not sure if the drape it a full one or not. She does have a gown on in the picture.  My only question is one of product.  I am familiar with yellow gowns being the non sterile ones used to enter an isolation room and blue ones being the sterile gowns.  Are there companies whose sterile gowns are yellow?  In the photo she has on a cap and mask, as well as a sterile sleeve for the ultrasound.  We always put a sign on the door asking people not to enter as a sterile procedure was in progress.  
netty10453
Is there any nurse out there
Is there any nurse out there who is willing to share there protocol on extravasation of vesicant drugs, i.e. application of cold, steroid cream , manual injection of antidote.  Who is responsible the M.D. or staff RN or IV therapist for the administration

Is there any nurse out there who is willing to share there protocol on extravasation of vesicant drugs, i.e. application of cold, steroid cream , manual injection of antidote.

netty10453
I think we are looking at

I think we are looking at different pictures, the one I see shows the patient with his johnny, with a chux under the arm, and a nurse with a mask and cap with no sterile gown

Is there any nurse out there who is willing to share there protocol on extravasation of vesicant drugs, i.e. application of cold, steroid cream , manual injection of antidote.

tamster
When I am done doing my

When I am done doing my initial assessment with the SiteRite, I have all of my supplies gathered,I then put on my mask and cap and prep the pts arm with Chloraprep for at least one minute.  I instruct my patient to leave his arm out and then I open up all of my supplies, put on my sterile gown/gloves, drape the patient and then do one more one minute prep with chloraprep.  It might be overkill but I would rather be safe than sorry.

mary ann ferrannini
 We do a 2-step prep
 We do a 2-step prep method. After we assess we put on mask,and cap and perform a one min prep with Chloraprep and allow to air dry. The assistant can also do this job if you are lucky enough to have one. The insertor  then put on their gown and gloves using a closed technique. The insertor then drapes (maximal precautions) and performs the second prep in the fashion. We also have an alternate prep for any allergies to chlorhexadine and that would be alcohol as step one and betadine as step two. If someone is very dirty we will use soap and water to clean the extremity and for milder cases of uncleanliness we will use alcohol before the 1st chloraprep
Robbin George
Based on guidance from the
Based on guidance from the words of M. Ryder we do a two step prep as well--After we assess and mark the arm the first prep is done as a pre-surgical scrub with CHG SAGE Cloths and the extremity is wrapped with a drape--As previously stated the   insertor then prepares themselves and the field according to full barrier bundle using a closed technique--Then we drape the arm and perform the second prep with the Chlorprep wand  

Robbin George RN VA-BC

kokotis
Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems

I think we should have a session on sterile technique given at this years INS and AVA meetings.  I know I could learn from lessons given by an OR Director.  I would love to hear this talk

kathy

Kathy Kokotis

Bard Access Systems

mary ann ferrannini
 Kathy K, so interesting
 Kathy K, so interesting that you said that. That is exactly what I do...I review the surgical asepsis and sterile technique and sterile field set-up guielines everynow and again. Then I post them in our office for review. After I read these I stopped putting any items near the edges of my sterile field and keep an inch around the edges clear. I figure it could only help. I Also never cross in front of the gowned inserter and communicate my movements if I am in the area.
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