Since the training of the Midlines we, the picc team nurses, have been also doing some us guided peripherals when a pt really doesnt even need a midline.
I started to think more about probe cleanliness, ( its got so many nook and crannies ) and the use of probe at the insertion site, keeping it sterile etc....
I have done lots of searchiing and it seems some use just the probe for pre assessment, then sterile gel and sterile probe cover for insertion. Others use a nonsterile probe cover, then apply a sterile cover for the insertion.
How are most of you doing this? I have read the recommendations by INS and am wondering what Probe covers are you using??? any specific company ??? they seem to be very expensive when I checked with Bard for some 12" probe covers...
I tried using gel then a large tegaderm but that is difficult to manuever and very messy. some spoke of a tegaderm and no gel for assessment????
We have a Bard Prevue that we havent used in along time because we struggled so much with it when first using it, priro to training on midlines. But.....now would like to resurrect it, if we used that then the probe /gel caps woud be sterile so that would help that.
But.....now we are so used to our much bigger screen for US and prefer to us the Site Rite 8
Thanks in advance, Gina Ward R.N. VA-BC
Hi Gina, when I was in practice, just a year ago, we used the same cover we used for our PICC insertions. As a team we decided we needed to use sterile covers/gloves/hair cover/mask. I used a central line dressing kit and used the towel to help establish a "sterile field". There is now a dressing available that allows you to clean the area, then apply the dressing part of the way, using the unsterile probe through the dressing, leaving the area are going to cannulate uncovered. Once you are in, you finish covering the site with the dressing. Here is the website for it. It's called the Ultradrape. https://bio-medical.com/ultradrape-ugpiv-barrier-and-securement-box-of-5.... I do not work for this company, nor have I used it, I simply was made aware of it in another forum and at AVA. Perhaps they would give a box to trial. 50/box. :-)
Sheila Hale, MSN, RN, CRNI, VA-BC, Austin, TX
At our facility, we use the Bard Prevue as well. We use our peripheral IV dressings (Centurion Versaderm 2000) as a cover for our probe along with sterile gel. We assess the site with the probe uncovered. Once we locate the vessel, we cleanse the site, place a dab of gel on our probe, cover with the dressing then use sterile ultrasound gel for insertion. I have also seen the dressing mentioned in the previous reply, but as of yet we have not tried them.
I don't use a cover for just an assessment for veins, I clean the probe in between patients with disinfectants. When I'm ready to stick after prepping skin, I cover the probe with tegaderm, I usually keep the tegaderm border and they seem to stick together. I don't put gel on the because it could get messy but I used single pavkaging sterile gel to the skin after it's all air dried. It works all the time.
We have adopted a Microtek sterile probe cover kit for our USGPIV, ML, and PICC insertions. Comes with the sterile probe cover, sterile gel, and sterile ruber bands. We disinfect the US wand with the appropriate cleansing solutions between patients. We use bleach for for GI isolation rooms. We also use have a small fleet of BARD Prevues that we have attached to mobile medical carts so inserters have the equipment at hand when placing lines.