IV Site Prep

cabbage patch rn · Dec 15, 2004

I use betadine then alcohol. That's how I was taught eons ago, and that's what is still contained in the prep kits.

EricTAMUCC-BSN, BSN, RN · Dec 15, 2004

How many of you consistantly prep your IV sites with Betadine (or something equivalent) rather than just EtOH? I used to work with a nurse who said that she'd read somewhere that EtOH prep was almost useless so she always used Betadine unless allergic. Just wondering what the general thinking is.

Bryan, I've wondered myself why everyone insists on betadine or cholorohexadine instead of just alcohol since they are all antiseptics. I was under the assumption that these solutions kill all cells including some epithelial cells. I know that iodine is an older treatment and that its use like many things maybe based more on tradition and marketing. I would imagine alcohol to be less expensive than brand name iodine solutions. I do not know how effective alcohol is as an antiseptic but have always assumed that it works well.

"Iodine's use in the treatment of wounds was first described in 1839. By the late 1800's iodine tinctures came into wide use as microbicides. Iodine quickly kills a broad range of microorgansisms. In laboratory test, iodine destroys many microorganisms and viruses within 3-5 minutes. How it kills is not exactly understood, but it rapidly penetrates cell walls, stops or interfers with protein synthesis, and reacts with cell membranes and membrane bound structures... Unfortunanetly the drawback of using Betadine solution is that the brownish stain it leaves on the skin is a bit unsightly, however this can be eliminated if the phlebotomist uses two solutions to cleanse the skin. The phlebotomist swabs the chosen area with Betadine. After allowing the Betadine to dry for a minute or two, the phlebotomist wipes the brownish stain away with sterile gauze pads soaked in 70 % alcohol. Then the puncture starts a minute or two after the alcohol wipe."

http://www.phlebotomypages.com/iodine.htm

PatrickJ · Dec 15, 2004

I use both. I use the alcohol pad mainly as a system to help bring out the vein. I use the betadine with a sterile wipe to create the sterile skin prep. Since the betadine leaves a film, it is more effective. Note. When I apply the betadine, I wipe the bulk away in a cleaning swipe. So looking at the site, you can not see the staining from the iodine.

I use betadine then alcohol. That's how I was taught eons ago, and that's what is still contained in the prep kits.

sparkyRN · Dec 15, 2004

our standard iv prep is wiping the site with betadine, allowing it to dry, then removing the betadine with an alcohol wipe. according to our unit director doc, betadine is only effective in killing infectants completely if allowed to dry completely before removing.

JVanRN · Dec 16, 2004

I just use alcohol for PIV's

Marie_LPN, RN, LPN, RN · Dec 16, 2004

I use betadine.

Tweety, BSN, RN · Dec 16, 2004

We have a prep that we're supposed to use on IVs, but no one does. We just use alcohol primarily.

I always thought alcohol was a good antiseptic?

allnurses Guide · Dec 16, 2004

I was taught to use betadine and let it dry . . the drying action is part of what kills the germs. Then alcohol.

But I don't use betadine most of the time. Just alcohol. Takes too long to wait for the betadine to dry. :)

steph

EMTI19 · Dec 16, 2004

"When prepping the client's skin for venipuncture, cleanse the skin with betadine and wait for it to dry. Do not apply alcohol after the skin has been prepped with betadine. If these substances are combined, they form a toxic material that may be absorbed through the skin."

-Fundamentals of Nursing, Second Edition, pg 1112

Jay-Jay, RN · Dec 16, 2004

We use chlorhexidine swabs. I know of at least one hospital where the protocol calls for betadine, letting it dry, then, just prior to the stick, wiping a strip of it away directly over the vein, with alcohol, to help her see the vein better.

...and it's the drying process that kills the bugs, regardless of the type of antispetic. When we clean a PICC line insertion site, we have to go over the skin 3 times with 3 separate chlorhexidine swabs, allowing the skin nearly a minute to dry inbetween each one.

aurora_borealis · Dec 16, 2004

Betadine then alcohol. And no fair blowing on the betadine to help it dry. Yes, I was actually told this.