Is this a true IgE mediated allergy? Most of the time it is not and the problem is something else like medical adhesive related skin injury (MARSI). Have you tried using a skin protectant solution on the skin under the dressing? This solution protects the skin. Lynn
the pt, a ONC Rad MD, believes she has a allgergic reaction. we have cavilon in our CVC central line kit, so ... likely we used that.
according to the pt, she developed such a reaction to tegaderm/CHG/iv 3000 that she developed CRBSI from her newly implanted port. now she needs a PICC for her 4-6 wk abx.
the pt claimed that she had a skin rash when chg appled to skin for routine blood cultures ... ...
if she dose have MARSI, what would be the optimal treatment plan?
3M has a very good education series with an excellent course call "Patient Safety: The Role of Medical Adhesives" by Janet Davis, MSN, RN, GNP, CWOCN There might be some insight in that course for you.
I would suggest Sorbaview as it has a different adhesive, we have seen good results with these tender skin patients. Proper preparation and correct removal of the device is essential.
McNichol, L., Lund, C., Rosen, T., & Gray, M. (2013). Medical adhesives and patient safety: state of the science: consensus statements for the assessment, prevention, and treatment of adhesive-related skin injuries. J Wound Ostomy Continence Nurs, 40(4), 365-380; quiz E361-362. doi:10.1097/WON.0b013e3182995516
This work was sponsored by 3M, so it is highly likely that the 3M course mentioned in another post will contain this information.
From your description, it is quite possible that the "allergy" is due to CHG and not medical adhesives. Sounds like it is time to educate this physician/patient and maybe get a referral to an allergist for testing. Lynn
Opsite used to be a good last resort for adhesive dressings. Sorbaview shield same concept almost a cloth type material with a gentle adhesive. If all else fails you may have to go to sterile guaze 3X weekly. That has workedfor me in home infusion...Not the best option but it's better than nothing.
Is this a true IgE mediated allergy? Most of the time it is not and the problem is something else like medical adhesive related skin injury (MARSI). Have you tried using a skin protectant solution on the skin under the dressing? This solution protects the skin. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
the pt, a ONC Rad MD, believes she has a allgergic reaction. we have cavilon in our CVC central line kit, so ... likely we used that.
according to the pt, she developed such a reaction to tegaderm/CHG/iv 3000 that she developed CRBSI from her newly implanted port. now she needs a PICC for her 4-6 wk abx.
the pt claimed that she had a skin rash when chg appled to skin for routine blood cultures ... ...
if she dose have MARSI, what would be the optimal treatment plan?
3M has a very good education series with an excellent course call "Patient Safety: The Role of Medical Adhesives" by Janet Davis, MSN, RN, GNP, CWOCN There might be some insight in that course for you.
I would suggest Sorbaview as it has a different adhesive, we have seen good results with these tender skin patients. Proper preparation and correct removal of the device is essential.
I will disclose a relationship with Centurion.
Here is the first paper released on MARSI
McNichol, L., Lund, C., Rosen, T., & Gray, M. (2013). Medical adhesives and patient safety: state of the science: consensus statements for the assessment, prevention, and treatment of adhesive-related skin injuries. J Wound Ostomy Continence Nurs, 40(4), 365-380; quiz E361-362. doi:10.1097/WON.0b013e3182995516
This work was sponsored by 3M, so it is highly likely that the 3M course mentioned in another post will contain this information.
From your description, it is quite possible that the "allergy" is due to CHG and not medical adhesives. Sounds like it is time to educate this physician/patient and maybe get a referral to an allergist for testing. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Opsite used to be a good last resort for adhesive dressings. Sorbaview shield same concept almost a cloth type material with a gentle adhesive. If all else fails you may have to go to sterile guaze 3X weekly. That has workedfor me in home infusion...Not the best option but it's better than nothing.
Jack