Hello,
We have had been taught the skin antisepsis (we use CHG wand) should be the last in the sequence before implantable port access with a huber needle so the CHG is the 'last' on the skin in order to fully penetrate layers of skin. So if a vapocoolant spray was used it should be first > immmediately cleanse with CHG >allowed to fully air-dry> then access. I was curious if this sequence is appropriate..
Follow the IFU/DFU forvthe product. Pain Ease is one of the products available. This is their link.
https://www.gebauer.com/painease-applications
Ty yes, I/we read the IFU however, since the vapocoolant isn't single sterile it is alot of doffing and donning and adding another product after the full cleansing had us pause and look at this process--collectively we felt that CHG should be last on the skin prior to access
Kathleen Eastburn Malinowski MSN, RNC-NIC VA-BC
By the time the CHG is allowed to air dry the effe of the spray will have been gone. IFU states to apply after cleani/disinfecting and that the effects will last approximately 60 seconds.
Would like to get Lynn's opinion.
https://www.sciencedirect.com/science/article/abs/pii/S0195670115001565
I dont know if these papers are helpful but thought you may be able to use them.
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F26044395%2F&data=05%7C02%7C%7C80e9b9e33a2a456c0f0508dd2b924049%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638714629377156310%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=JU0lAVAhRPRz8F84QVM99EjNZR8pUMPUnKItRPW1F2g%3D&reserved=0
https://f.hubspotusercontent10.net/hubfs/150313/docs/Pain_Ease/Pain%20Ease%20FAQs%20SPEC%20838.4.pdf
https://www.gebauer.com/resources
https://www.sciencedirect.com/science/article/abs/pii/S0195670115001565
Conclusion
These vapocoolant sprays are not allowed to have the word "sterile" attached to the label, it is still manufacturered in a way that tests for and reduces risk of contamination. FDA has requirements for testing and how it must be used based on those tests. These sprays are not labeled as sterile because they are in a spray container which is not possible to be sterile. These solutions have a very limited time for effectiveness. I have had numerous joint injections with these solutions where the skin antiseptic was applied first, allowed to dry, then the spray, then the stick immediately.
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861