We are changing the dressing on the triple lumen catheter several times daily due to the poor skin integrity and weeping of the skin. The patient has severe pain with the dressing removal and cleansing of the skin. Does anyone have any suggestions on how to keep the dressing intact and how to do this without causing pain to the patient? What type of dressing could be used in a patient in this situation? We also are using a stat lock to secure the line. To remove it with alcohol, as recommended, also causes increased pain. If we do not use alcohol, her skin comes off with the stat lock. What should we do?
Do you have an enterostomal/wound care nurse specialist in your facility? If so, I would go to that nurse specialist for guidance. They are skin and dressing experts. 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
In addition to Lynn's suggestion, we have begun using the Securacath (http://www.interradmedical.com/) for a subset of patients with securement challanges. This may be a part of the solution for this patient.
I have no vested interest in the marketing or sale of this product.
Dave B
David Bruce RN
Thank you David. I will look into this product. We already had a wound care nurse look at the patient and she did not have any suggestions.
I was very impressed with this new dressing after seeing it at AVA in San Antonio. Traditionally we have not been able to offer patients like this very good solutions with central line securement and anti-microbial protection. Although I have not yet used this dressing(that will soon change!) I loved thd idea of silver and Chlorhexadine impregnated into a Silicone dressing! Silicone is very gentle to the skin and I wonder if this would be a perfect solution for this patient. With the weeping even if the silicone was held down with kerlix you would still get anti microbial protection. I am excited to try this product as it seemed very well thought out to me. I have no affiliation with the company but there website is Covalon.com. I hope this is helpful and I certainly will give more feedback when our company gets a chance to use the dressing.
Stephen Harris RN, CRNI, VA-BC
Chief Clinical Officer
Carolina Vascular Wellness
Covalon IV-Clear
Here is the link to this product. http://www.covalon.com/ivclear-antimicrobial-clear-silicone-iv-dressing
No, I don't work for them, just have medical interest.
I appreciate your advice, thank you. I will definitely look into the product.
As an additional suggestion, consider the product BioSealCVC. I do work for the company, but I do not want that to hinder the care of the patient. As a clinical specialist for a large vascular access team prior to my working for Biolife, we used BioSealCVC on Steven-Johnson patients with good success. The challenge is how to secure dressings and avoid changing them with any frequency. What we found was that one component of the product, the hydrophillic polymer, helped keep the environment under the dressing dry enough that the dressing would stay on without requiring frequent changes. Using a non-sting skin prep like Cavalon by 3M is also a suggestion to protect the skin from the dressing. BioSeal's other component, K+ferrate, forms the seal at the site which further keeps the site dry from oozing and therefore the dressing has a better chance of staying on longer. If you would like to contact me personally I would be happy to talk to you further.
Lauren Blough, RN, BS, CRNI, VA-BC
Clinical Development Manager
Biolife, LLC "Makers of StatSeal"
Here is a posible solution for multiple-lumen catheter securment and site dressing COMBINED...Take a look: http://www.centurionmp.com/customer-support/video-library/
Good luck and all the best to you and your patients.
Tom Burns, RN BSN
Tom Burns, RN BSN
Clinical Nurse Edu
Here is a posible solution for multiple-lumen catheter securment and site dressing COMBINED...Take a look: http://www.centurionmp.com/customer-support/video-library/
Good luck and all the best to you and your patients.
Tom Burns, RN BSN
Tom Burns, RN BSN
Clinical Nurse Edu