Have a pt needing a PICC (can't find a peripheral site even w an U/S). Has had 2 prior PICCs with transparent dressings and both times ended up with serve skin breakdown and staph infections. Any well thought out suggestions would be appreciated. Thanks, Nancy
try mepilex with border, MD Anderson uses this and we have used successfully on patients that have sensitive skin issues.
Good Luck
Beth Ferguson, RN, CRNI
Indiana University
elizabeth ferguson
Our first step with any adhesive reaction is always Cavilon No Sting Barrier Film (NDC 8333-3345-01). This will solve the problem most of the time (~90%). If still a problem we change to a different TSD brand, usually the Smith and Nephew IV3000. Regarding the barrier film, make sure you apply it heavily, and allow to completely dry before covering.
Tim
Are you sure it is a reaction to the dressing? I have seen terrible rashes under dressings due to wet Chloroprep. The dermatitis occurs when the dressing is applied without letting the chloroprep dry completely first.
If it is the dressing, the No-Sting Barrier film works very well, and there is no reason the PICC cannot be dressed with Gauze and tape. It would just mean that the dressing needs to be changed daily. This is within the CDC guidelines.
Chris Cavanaugh, CRNI
Chris Cavanaugh, RN, BSN, CRNI, VA-BC
Gail McCarter, BSN,CRNI
Franklin, NH
We have switched to the TegadermCHG, and I have found that most of the patients that we have been using special order dressings (sorbaview or Smith & Nephew) tolerate these well.
Gail McCarter, BSN,CRNI
Franklin, NH
Thanks for the responses. In this case, I carefully reviewed the patient's record and found no indication for the PICC except her desire for IV pain meds when she could take PO. Her Doc agreed.
I'll get some different products because she will be back and they may be useful for others.
Nancy S.