How much betadine to prep with?

rachelyp · Jul 25, 2015

If it makes you feel better, when I first started in the OR I was a sloppy prep-er as well. The more you do it, you'll get better control of the sponges. It also never hurts to watch others on how they prep.

Betadine is bacteriocidal and kills existing bacteria on contact. If you apply a very thin layer you might miss a spot without knowing it or might not apply enough to kill the bacteria on the skin. What is more important, having a clean prep or working towards preventing your pt from getting an infection?

Our kits come with two types of application sponges. One set for scrubs and one for painting. With the scrub solution. I soak the sponge in the scrub solution and in my hand ring out half of the scrub solution and foam it up before I apply it to the pt. Then when painting I dip the sponge and squeeze about half of the solution by pressing against the inner edge of the tray before applying it. Hopefully I've helped a little.

peabozzle · Jul 25, 2015

I am also a messy prepper. I was taught "a messy prep is a good prep" ha ha! I have gotten a little better about not flinging Betadine all over, but I use a lot of it when I prep. I good prep is very important, more important than how "clean" I keep the surrounding area

kinbari08, BSN · Jul 25, 2015

I too was taught that a messy prep is a good prep. And I too tend to get betadine everywhere, but I've gotten better at it. I'm very meticulous about getting all of the surgical site covered with prep and I think that is much more important then keeping the other areas clean. You can always put a chucks or a towel down before you prep if you are afraid you will make a mess. I do that for cystos.

Editorial Team / Admin · Jul 25, 2015

I'll admit to being curious as to why you're prepping with betadine. Studies have shown that Chloraprep is more effective and lasts longer- betadine is inactivated by blood, so it's only good until incision is made whereas Chloraprep has shown to reduce bacteria on skin for up to 48 hours even if exposed to blood. My facility's surgeons have almost exclusively moved to Chloraprep, with the exception of open wounds, mucous membranes, allergies, and 1 or 2 surgeon preferences.

Either way, back when we were prepping mostly with betadine, I was always told the messier the prep the better.

Jensmom7, BSN, RN · Jul 25, 2015

The messier the prep, the better. Heh.

Reminds me of when I still used to wear white uniforms, back in the 80s. I was holding a kid for a spinal tap. The Neurologist preferred Betadine spray as an initial prep, and was very liberal in applying it.

Once the tap was done and we were cleaning up, he looked at me and just said, "Oops."

I looked like an Oompa Loompa. *sigh*

mhy12784 · Jul 25, 2015

My hospital uses like 90% betadine

A lot of the surgeons don't want chloraprep. There's a few who exclusively use it, but not many.

Presumably I think a lot of this is old timers don't want to change (used it for xyz years, why stop now), nobody wants to light a patient on fire and get sued, and the waiting 3 minutes rule

Editorial Team / Admin · Jul 26, 2015

Sad that in the face of evidence (Chloraprep more effective against more organisms, for longer amount of time, in spite of blood) healthcare ppl are reluctant to change practice.

To benefit the patient.

arack05 · Jul 26, 2015

Sad that in the face of evidence (Chloraprep more effective against more organisms, for longer amount of time, in spite of blood) healthcare ppl are reluctant to change practice.
To benefit the patient.

Not that im in favor of one of the other. But to be fair...

Chloraprep costs around 400% more than betadine I believe (yes the cost would probably get completely negated and them some by reducing infections)

And chloraprep has a much better chance of landing you in a lawsuit (via an OR fire)

There was actually a huge case at a major hospital in my area recently where there was an OR fire because of chloraprep. Needless to say support for Chloraprep (which wasnt high to begin with) wasnt looking good

Editorial Team / Admin · Jul 27, 2015

*sigh*

It's never simple, is it?

RN-2014 · Sep 18, 2015

I prefer the chloraprep to betadine. The only cases I use B/B for are urology, cataracts and GYN cases. One of the tips I use when doing lady partsl/ perineal preps is to put a small garbage bag under the patients bum before starting and pulling the bag out after. Chloraprep is very safe when used correctly ie not put on hairy body parts, waiting the 3 minutes ect. Usually the surgeon and first assists are donning gowns and gloves or scrubbing while I'm prepping and after we can do the time out while we are waiting for the prep to dry. My least favorite prep is CHG. It is super slippery on feet and it makes them hard to hold by the toes while prepping the rest of the leg.

Editorial Team / Admin · Sep 18, 2015

My least favorite prep is CHG. It is super slippery on feet and it makes them hard to hold by the toes while prepping the rest of the leg.

Have you used Technicare yet? It's even worse than the hibiclens- not only is it slippery while you prep, it stays that way for quite some time and you have to swab it for a full 2 minutes.