2 glove technique? HUHH?

[RN1822]

OK, so today one of the Respiratory therapist had some time and was nice enough to let me shadow him as he was caring for a pt that frequently decannulates. ( I work in LTACH). He put on two pair of clean gloves and then a sterile pair on top of that to make him "extra sterile"? I asked him about that technique and he said that was the 2 glove technique. I am new here and don't want to appear insane but, really......I have never heard of this. Is this specific to Respiratory Therapy or is this guy pulling my chain. We were replacing a trach strap.

I thanked him for his time and went to finish up my pateints. Has anyone else heard of this?

[Altra, BSN, RN]

I put sterile gloves over regular gloves for sterile procedures all the time, and I double glove for all sorts of situations.

As long as your coworker's technique was proper while donning and wearing the sterile gloves ... it doesn't really matter what's underneath.

Is it possible that you just missed some humor or sarcasm?

[abiklags]

I've never used it but I've seen others do it for messy situations

I also know an EMT who double gloves if he gets called to OB calls and has to catch the baby. The OB kit his co uses only has latex sterile gloves and he's allergic to latex so nitryl/vinyl gloves go on first then the latex

[wooh, BSN, RN]

My question is why did he need sterile gloves at all just to change trach ties?

[tothepointeLVN, LVN]

The OP says the patient frequently decannulates so maybe so he can recannulate if that happens.

[KelRN215, BSN, RN]

My question is why did he need sterile gloves at all just to change trach ties?

At my old hospital, the policy was to wear sterile gloves to change trach ties... I always thought it didn't make any sense .

[wannabecnl]

I'm trying to remember what they taught us in nursing school about changing trach ties; our fundamentals text does not mention regloving with sterile gloves when changing the ties at the end of total trach care, though they are used earlier. I would think the gloves would get contaminated during the process whether or not the cannula came out.

Another double-glove application (which bears no relevance to the topic at hand--so to speak) is when removing IVs. I put on a pair of clean gloves and then double-glove my right (dominant) hand. This allows me to pull the extra glove inside-out over the removed catheter with my left hand to keep it covered and not leaking or getting blood on the sheets while applying pressure with my still-gloved right hand.

[tothepointeLVN, LVN]

Maybe the theory is a dirty sterile glove is cleaner than a dirty clean glove and if the cannula accidentally comes out you don't have time to reglove. IDK I wouldn't do it that way. I always thought wearing multiple gloves increased the risk of the gloves breaking and exposing you though I might be thinking about downstairs gloves.

[sapphire18]

Yeah, changing trach ties is not a sterile procedure...common sense:)

However, I always thought double-gloving was like doubling up on condoms...more likely to break. I will say that I recently double-gloved for the first time in my life for a few messy GIB code browns...

[sapphire18]

Maybe the theory is a dirty sterile glove is cleaner than a dirty clean glove and if the cannula accidentally comes out you don't have time to reglove. IDK I wouldn't do it that way. I always thought wearing multiple gloves increased the risk of the gloves breaking and exposing you though I might be thinking about downstairs gloves.

Haha tothepointe I see we think alike!

[Guest343211]

I think the language he was using is what is confusing. There is no such thing as "extra sterile". As a long-time operating room nurse and CST I can tell you that something is either sterile, or it is not. It's just that simple. However, using multiple gloves for the purposes people have described above is a common technique so that you can easily pull off a pair of gloves and have a fresh pair underneath (sterile or clean, depending on what you are doing). In the operating room the scrub person will frequently double glove with two pairs of sterile gloves. In many places this is policy for the OR. This isn't to make them extra sterile though, it is done to reduce the risk from needlesticks and is also useful if the top pair rips, you are still sterile underneath and can apply a second glove on top at a convenient time rather than I need another glove "right now".

This is exactly correct. And if one wants to done gloves that are sterile, one needs to be careful when putting the sterile ones on, or they are blown. This seems to only make sense for the upon scenario described by Taketwo, or if for some reason you want to double protect yourself. I have been a nurse for > 2 decades. Only once or twice have I doubled gloved, and not for sterile procedures. The clean glove-doubling was only b/c we kept getting in the cheapest gloves the hospital could find, and we found zillions of holes, leaks, and rips in them. In general, it's excessive. I will say, however, that my hands look like a 90 year olds b/c I have scrubbed them so often over the years, it's insane.

I have never doubled gloved to put in an IV or an arterial line--need to feel. I don't think I have even double gloved for some of the biggest and nastiest trauma, burn, or surgical wounds with MRSA.

But one way a person can get infected is to not have a mask on non-in-line suction on certain patients that are ventilated--and then the RT just turns the tubing in such a way so that the pressurized back wash of infected sections flies up into the nurse's nasal cavity. This I have seen. Don't let anyone tell you not to wear masks while doing open suctioning on certain patients. Seriously. Bring your own masks if you have to.

All the double gloving and gowns in the world, however, are not necessarily going to protect you from a heavy bleeder under certain circumstances. I mean you do your best to prepare ahead of time, but I have been soaked in blood down below my bra and panties. Just the way certain codes rolls, even if you are protected. The idea is to limit it as much as possible, but it can be hard to prepare for every extreme situation, when the fellow covering the unit doesn't clue you in to things ahead of time.

Crap--code browns--they are a joke to me after some of these other situations.

[nurseladybug12]

I would think that if you have to wash your hands in between glove changes, especially from clean gloves to sterile gloves, double gloving would defeat the purpose because you should be washing your hands in between if that's what's best for the patient.

[tothepointeLVN, LVN]

The part I loved the most is when he told you this was the "2 glove technique"