Published Aug 10, 2010
carebearsRN
140 Posts
Why is betadine rubbed onto the skin for those with shellfish/iodine allergies before surgery/procedure?
CrazierThanYou
1,917 Posts
I have no idea. I thought Betadine WAS iodine. (I'm just starting nursing school...)
roser13, ASN, RN
6,504 Posts
Not sure what you're referring to. In my facility we avoid using Betadine if the patient has a shellfish allergy.
What do you mean by "rubbed onto the skin"? Are you talking about the surgical prep (cleansing) or rubbed on as in testing for an allergic reaction?
CrunchRN, ADN, RN
4,549 Posts
I thought hibiclens was used instead if allergies to iodine/shellfish.......
Redhead28
200 Posts
If a Iodine/shellfish allergy is known another prep is usually used.
grandmawrinkle
272 Posts
If it was, it was an error. People with iodine allergies should not have betadine.
I am wondering if you saw a different type of prep. Chlorhexidine preps now come tinted -- sometimes they turn the skin reddish like betadine does. I have also see CHG scrubs be bluish.
Whew! I wasn't wrong after all!
i believe rubbed on to test allergic reaction...
mamamerlee, LPN
949 Posts
This would have to be done 2-3 days before surgery to really know if an allergy exists. I am not allergic to iodine or shellfish, but developed a bad dermatitis from frequent hand washing w/Betadine. Chlohexadine would be my choice.
brownbook
3,413 Posts
This confuses me also. I am paraphrasing from a nursing journal, Nursing 2009
Iodine is not an allergan. Iodine is found throughout the body in thyroid hormones, amino acids, etc. If a patient says they are allergic to iodine it is something else in the solution not iodine. If a patient says they are allergic to shellfish again it is not iodine, it is primarily the muscle protein tropomyosin. Any time a patient states an allergy they need to be further questioned as to the type and severity of reaction.
HamsterRN, ADN, RN
255 Posts
The iodine/shellfish allergy is a myth that just won't go a way: an allergy to shellfish does not equal an allergy to iodine. Long ago, it was assumed that those with shellfish allergies were reacting to the Iodine since it was assumed that all meat was the same. We have known for some time that this is not the case and that different proteins present specific allergens.
This is on top of the fact that it is not possible to have a true allergy to iodine. Allergic reactions are caused by an over-sensitive immune response to an allergen-antibody reaction. Iodine is an elemental molecule and does not contain the complex allergen markers that are required to initiate an allergic reaction. Also, Iodine cannot be avoided, it is present an any diet and is required for the normal functioning of the body.
Reactions to iodine contrast is real, but it is considered to be due to the osmolarity of the solution and not to the iodine itself.
Anaphylaxis: eMedicine Emergency Medicine
Shellfish Allergy and Iodine -- IV Dye and Shellfish Allergies
The Australasian Society of Clinical Immunology and Allergy - ALLERGIC AND TOXIC REACTIONS TO SEAFOOD
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mustlovepoodles, RN
1,041 Posts
I think it's just easier for people to understand "I'm allergic to Betadine" than to have the whole it's-not-the-iodine-it's-something-else-you-wouldn't-understand conversation. I have been sensitive to Betadine ever since I first started nursing--about 35 years. Now, I dont' know what it is about Betadine that makes me break out, swell up and itch, but I'd just as soon avoid it altogether. I had thumb reconstruction surgery a couple years ago. I told everyone I met in the OR that I was "allergic to Betadine"--intake nurse, anesthesiologist, surgeon, circulator. Yeah yeah yeah...The day after surgery, when I finally got my eyes open what do I spy peeking out from under my bandage? Gold Or, I should say Greenish-gold. What I learned later is that "someone" scrubbed my arm with Betadine. "Someone else" stopped her and reminded her that I was "allergic." Rather than scrub the Betadine OFF, she then poured Hibiclens over it "to neutralize it." Of course, I didn't discover all this until I went to have the bandage removed and sheets of skin peeled off. The skin on that part of my hand looks like I've suffered burns and it will never look normal again.
So, as far as I'm concerned, i will be "allergic to Betadine". And in the future I will write that directly on the body part which is about to undergo surgery...