Submitted by Mary Lynn Rae, Nurse Educator, Children's Memorial Hospital on Mon Jul 26 14:29:51 2010
Hi:
Is there a standard for changing CVC dressings after initial placement? One of our attendings wants the very 1st dressing (24 hours after placement) changed at 24 hours because of oozing as she thinks that this is a risk for infection.
Any literature to back this up would be great!
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CVC and dressings
Your attending is correct. While there is no published standard, best practice is to change @ 24 hours post insertion and certainly if wet or bloody.
If there is a bloody
If there is a bloody dressing, it requires immediate change. Dressing change 24 h after CVC insertion is recommended if there is bleeding. Skin can not be rendered sterile. Blood is a great medium to support growth of organisms, thus the reason for changing these dressings. A change at 24 hours is not needed if it is clean, dry and totally adherent to the skin. CDC uses the language that a dressing should be changed when it is wet, dirty, or not occlusive. I would consider a bloody dressing to be a dirty and possible wet dressing. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
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