Effectiveness of alcohol??

[Lady_in_red]

A doctor recently told me that the alcohol prep pads we use before starting an IV or administering an injection are useless. He said there is no literature to support alcohol as an effective means of reducing infections before these procedures and that cleaning in a circular motion did nothing as well. Needless to say, I was surprised! My instructors have been adament about both of these subjects. I did a short literature review and I can't find anything useful. I found research studies in favor of the alcohol hand sanitizer, but not for the little alchol wipes. Anyone have any links or information? If what he said is true, then I would like to use a different antiseptic.

I've used search words like "alcohol prep" "alcohol" "Bacteria" "nosocomial infection" "prevention" "preparation" & "injection" in the word search.

Any suggestions would be appreciated.

Thanks for your help!

[MedSurgeNewbie]

Foud a few, I am not sure if you are looking for research studies or not

I used this search in google

Effectiveness of Alcohol preps in IV insertion

This one was interesting

http://www.infectioncontroltoday.com/articles/521feat4.html

[TazziRN, RN]

There may be some truth to that, since labs are now using those little swabs to clean before drawing.......I wanna say physohex but I think I'm dating myself. Even our IV starts kits have those swabs in them.

[dano]

I've always been under the impression that all we're really doing is pushing away dead skin cells from the injection site for a more proper penetration of the needle, not really to kill bacteria. That's nothing I can cite a source from though, I'd love to here more on this.

Imagine me trying to argue with my clinical instructor that I'm not using wipes anymore because I read studies saying they're useless. Think she'd hang me? LOL.

[TazziRN, RN]

Not even killing bacteria, just cleaning the skin.

[dano]

Not even killing bacteria, just cleaning the skin.

So if supposedly the wipes don't do anything besides clean the skin, what's more cost-effective to clean the skin with? I see boxes of wipes all over the place. I can't imagine using gauze pads + water or cotton swabs being much cheaper.

Perhaps in the grander scheme of things that's why we use them, cost.

JMO though, I'm running on very little sleep right now so this might not even make sense.

[nurse4theplanet, RN]

Check these out:

http://www.wisegeek.com/why-is-alcohol-a-good-antiseptic.htm

http://cal.vet.upenn.edu/surgery/4629.htm

I too agree that it is not necessarily the most effective antiseptic, but it is not entirely useless. I do believe it is the most cost effective choice. For any central line starts and dressing changes we use chloraprep and betadine...and this is obviously why.

[meownsmile, BSN, RN]

We have an anesthesiologist that says the same thing. Says IV starts should be preped with betadine swabs and forget the alcohol.

[TazziRN, RN]

Chloraprep!! That's it!

[prmenrs, RN]

The alcohol helps mechanically clean the skin, and does kill some bacteria. Decreasing the # of bacteria on a piece of skin you're about to pierce w/a sharp object.

You should use something stronger for an IV insertion, or a blood culture, but for an injection or a bedside glucose, alcohol is just fine.

[Mags4711, RN]

This is merely a thought provoking question:

If the alcohol preps are nearly useless (don't kill a lot of bacteria) then why are all the hand sanitizers the "way to go" in hospitals now? We are told you may use them up to five times before you have to wash your hands (unless you know you got a body substance on them or they are visibly soiled). The active ingredient in them is: (yep) Alcohol, and not even the 70% Isopropyl that the preps contain, Purell (what we use) is only 62% Ethyl (the Iso is more effective than the Ethyl).

[RunnerRN, BSN, RN]

So what does everyone use to prep before IVs? We are supposed to use Chloraprep - even had an inservice a few weeks ago that we can use it for blood cx draws. I use the chloraprep on adults, but still do the betadine/alcohol combo on kiddos.