How to prep around infected tissue?
- 0Aug 25, '11 by LAM2010Hi, I've been an OR nurse for a year and a half now, and just when I think I know how to do something, I won't get a case like it in months and then by the time I go to do it in a case, someone tells me I do it wrong.
You prep clean to dirty. An infected wound is dirty. AORN articles I've found are vague.
I don't know where to start with a nasty infected wound. And what if it's on the arm - you've got the dirty wound, then you've got the armpit... so frustrating....
And of course when I have a more experienced person showing me, I'm under pressure because her arm's getting tired holding a big fat leg, and the surgeon is standing there waiting. So I retain nothing.
What source can I go to for definitive answers and not vague ones?
p.s. I think that one reason we starting prepping the foot at the amputation site (then continuing up the leg to the knee) could be that, since I'll be holding this leg by myself with no help, I have no choice but to prep that way... ? I hate for that to be acceptable, if this is why someone just told me to do that today.
LoriLast edit by LAM2010 on Aug 25, '11
- 1Aug 26, '11 by canesdukegirl, BSN GuideI had one of these today, in fact. We had a big open infected wound. We prepped inside the wound with CHG from the middle to the outer edges. Then we used Chloraprep to finish prepping out the skin, working from just around the edges of the wound outward.
- 0Aug 27, '11 by brownbookHi, I am not an OR nurse. I work pre and post op. I have occasionally done moderate sedation in the OR.
I can sympathize with your feelings, frustration. Sounds like situations I get myself into far too often. FINALLY after nursing for almost 20 + years (in a wide variety of areas), I am learning, getting comfortable with, asking a doctor or surgeon, "How do you want this done?"
Every journal you read might give vague or even conflicting information. Every surgeon you ask might give a different answer.
The surgeon was standing there. Simply say, "how do you want this preped?" Most men (hate to be a sexists, but still most surgeons are male) like specific direct questions. I remind myself of this before I ask my "dumb" question. Probably a better way to ask in that case would be. "Do you want me to scrub the wound with _________." (name the specific prep you normally use.)
You don't have to, and l NEVER will, know all the answers. If the surgeon gives you the "look" (rolling of the eyes, etc.) or an exasperated sigh, just toughen up you skin. (I know easier said than done, only took me 20 years!) Your question is completely appropriate!!!
Please excuse any spelling or typos, my spell check suddenly disappeared?