Comments on: Handwash

By: MacDoctor

MacDoctor — Tue, 03 Nov 2009 10:46:38 +0000

PIC lines are usually done with full drapes/gowns/gloves. Most long lines are put in as per normal IV technique. Subclavians and external jugular lines are usually done as emergencies and the technique is very variable.

By: Richard

Richard — Tue, 03 Nov 2009 06:09:50 +0000

One of the most dangerous (from an infection point of view) procedures is putting in a central venous line. There is good science to show that infections can be dramatically reduced if it is donewith full surgical drapes. Anyone out there with hospital experience: What proportion of central lines are put in with full drapes?
The place where antibiotic resistant bacteria really proliferate is the intensive care unit: lots of invasive procedures, very vulnerable patients, most on antibiotics. The infection control advice which everyone is taught is for staff to decontaminate their hands before and after every patient contact. If you count up the number of patient contacts a nurse has in an intensive care unit in an hour, and multiply that by the number of seconds it needs to do an effective handwash (the type that the old trout would do), you get to many more seconds than there are in an hour. The nurse would also have raw hands in less than a day (and be off on ACC?). If a full traditional hand wash is demanded, it just won't happen. The alcohol gel may in theory be less effective, but it is a lot easier to comply with, so in practice much more effective.

By: old trout

old trout — Tue, 03 Nov 2009 03:49:08 +0000

As an old fearsome, retired senior , OR nurse, may I opine that most young, new graduates wouldn't know a sterile or clinically clean field if they wombled across one and fell into a pit of guano and frigging sheep crutchings. You would pity the poor wee soul who approached me or mine to do some procedure without handwashing, or whatever was required. GRRRR …