Published Mar 3, 2013
cjg10RN
12 Posts
Do you prep the face and other areas with with mucous membranes with iodine if the patient is allergic to IV dye and shellfish? If not, what is an alternative to Chloraprep?
Thanks
ORoxyO
267 Posts
Chloraprep does not have iodine in it. (not sure if that's what you meant)
What about Exidine? We use that for lady partss, etc when we can not use iodine.
GonnaBSN
83 Posts
On questions like this, you can call your hospital pharmacy for a quick response. I think that's the safest way to care for the patient.
I haven't heard of Exidine. I don't think my hospital has it. I will ask though. Is it safe in the mouth? Currently we use baby shampoo for lady partsl preps when patients have an allergy to iodine. I haven't found anything other than 1:1 sterile water/betadine for intra-oral procedures. Not sure about baby shampoo in the mouth. I realize that the mouth will not ever be clean. Just curious if the was anything else available. No chloraprep in the mouth.
cass1320
41 Posts
If your hospital has an OR, it should carry a sterile chlorohexidine rinse that you can use on mucous membranes (they probably carry it even if they don't have an OR). Just know that if you use these, you have to use a LOT and thus it takes longer to dry.
Baby shampoo isn't sterile and does not contain an antimicrobial, so it shouldn't be used. Plus it can really mess with the lady partsl pH and possible increase the patient's risk of a UTI. Check you're hospital's policy and procedures, there should be a provision in there for sterile procedures on iodine allergic patients.
I'm not sure about oral procedures. It's been a while, but I'm pretty sure when I've done tonsils etc we didn't use any prep at all. What kind of oral procedures are you doing?
Exidine is pretty common. Maybe you know it by the name Hibiclens. We always use it to replace iodine when a wet-prep is indicated.
Rose_Queen, BSN, MSN, RN
6 Articles; 11,936 Posts
Another name might be DynaHex. May not be the exact same item, but when we have a preference card stating Hibiclens, we substitute DynaHex, which is the solution we stock.
We used to use Technicare for iodine allergies; however, we no longer stock it (if it's even available anymore- we pulled it due to a recall; not sure if that was resolved or not). Now, we use sterile saline if ChloraPrep and betadine are both contraindicated. Not bactericidal, but won't cause an allergic reaction.
We do have a surgeon who doesn't believe in iodine allergies because, well, it is a naturally occurring element that probably can't be avoided, and the allergy isn't to the iodine itself. Instead, he will do a test patch somewhere to see if a reaction occurs.
ILoveSpring&Fall
71 Posts
Have any of you read this article referenced on Pubmed: The relationship of radiocontrast, iodine, and s... [J Emerg Med. 2010] - PubMed - NCBI I have a severe shellfish allergy, but I'm not allergic to iodine. The allergen that caused me woe was actually a protein in shellfish, not iodine.
subee, MSN, CRNA
1 Article; 5,897 Posts
Iodine preps do not affect patients with an IVP dye allergy. Needs to be washed off well because if not it makes EVERYONE itch.
monkeybug
716 Posts
Nope, won't do it. My best friend discovered that her shellfish allergy extended to iodine after she was prepped for a Foley with Betadine. We use Hibiclens if the patient has a betadine/shellfish allergy.
Fun2RN,BSN, BSN, RN
5 Posts
If a vag, etc prep is needed, I usually ask the patient about the allergy, and then let the surgeon decide on whether to use the Betadine prep anyway. Unless it is an IV Contrast issue, there's usually not a problem.