Surgical preps for cardiac patients

NurseLumpia · Nov 16, 2012

we use iodine scrub then chloraprep

Editorial Team / Admin · Nov 16, 2012

CHG shower the night before and morning of, chloraprep paint in OR.

catherinefran · Nov 16, 2012

Sorry should have been more specific. Patients have already had chlorohexidine scrub Preop. We currently use iodine solution to paint surgical site. Two nurses paint patients chest, abdomen, groins and both legs circumferentially to ankles. The legs are free limb draped (using a perigroin drape) and the unprepped feet are in isolation bags. There are two surgical sites here. The chest and the legs. Should one nurse be only painting the chest? While the other is prepping the legs? Should the "leg nurse"be using separate paint brushes for each leg?

Editorial Team / Admin · Nov 17, 2012

Legs are placed on a leg holder to hold them up. We prep from chin to toes, including the entire foot. One nurse preps the groin while another preps the chest. Then each nurse takes a leg, prepping thigh to toes as far around as possible. Then, we grab the prepped feet and lift the legs with one hand to finish the circumferential prep with the other hand- requires some decent arm muscles. The legs are then placed back on the leg holder that is now covered with a sterile drape that not only covers the entire leg holder but also the bed between hips and leg holder. The chest is prepped a second time. Then, the two people prepping hold the legs while an unsterile person removes the leg holder, the scrubbed person places a drape under the legs and over the perineum, the people holding the legs then place them on the drape and the scrub person finishes draping out the torso.

This is similar to what we use:

We us separate chlorapreps for each part: one for the chest, two for the groin, each person uses one for the legs before they are held up and a second while holding them up, and then a separate one for the second chest prep. So, we end up using at least eight, but usually more for some of our larger patients. And if we are doing a radial artery harvest, that's at least another 3.