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Sue Witkowski
CVAD Dressings at Insertion

We will begin using biopatch at our facility next week. Our current practice/protocol for CVAD dressings is gauze at insertion, then change the dressing at 24 hours with a semipermeable membrane. I am inclined to continue this practice and place the biopatch at the 24 hour dressing change. We clean the skin at insertion with CHG and it seems difficult to predict the amount of post insertion oozing - I have seen high INR pts not bleed at all and those with no coag issues experience a fair amount of bleeding. What is the practice at other facilities?

Gwen Irwin
CVC dressings changes at 24 hours

When we started using Biopatch, we eliminated the 24 hour dressing change and we quit using gauze at insertion.  We placed the Biopatch at the time of insertion.

Biopatch is effective if less than 50% saturated.  So, bleeding at the site or oozing at the site doesn't require a prediction.  This includes patients with high INR.  It is a rare patient that oozes enough to saturate the Biopatch more than 50%.

This has been our practice for over 5 years.

Gwen

lynncrni
I have not read the Biopatch

I have not read the Biopatch instructions for use in a while, so can't remember what they state. But I have questions about any practice that allows any dressing with visible blood to remain on any catheter insertion site for extended periods. The bottom line from CDC and INS is that any dressing that is wet, dirty, or nonadherent should be changed immediately. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

LIP
Change the Dressing

Gauze to start until you achieve hemostatis is the way to go. Once you go to a dressing, dirty is dirty so change it if looks dirty.  If I am correct, unless you neutralize the CHG you now use at insertion with say another product like certain skin prep's around the IV site,  you should have 48 hours of protection at the site from the CHG prep.

 

I puckett

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