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well marylynknowles, I have done hearts at 2 different hospitals and one hospital did it with the circle doing the betadine scrub then dry and the scrub tech doing the betadine paint.
the other hospital the circle did entire prep. it was a complicated prep but when you think about it, it was a good prep.
the circle first prepped the chest to umbilicus, then changed gloves and did the legs to the groin. then changed gloves and did the groin. then using an alcohol soaked lap sponge, total of 5 laps. 2 on the chest area, one for each leg and one for the groin. (changing gloves inbetween chest , legs and for the groin) then the circle did the betadine paint, using the same technique as the betadine scrub. is that clear as mud??????????:biggringi
Marilyn,
Where I work in Mississippi, the floor nurses shave the pt no more than two hours prior to surgery time. Once in position and intubated, etc, etc, we begin the prep with the legs up on a leg holder and prep all around the legs, groin, abdominal area, and the chest up to the chin and ear lobe and out onto the upper arm, whatever skin can see the light of day is going to get "painted". We use a product called Duraprep. You paint it on with a sponge applicator. We use about six per patient. It is much neater and not as sloppy /wet as a traditional Betadine scrub/prep. We change gloves and of course change applicators when indicated. Although we are a new program, ongoing for about a year, we have not seen any post op sternal infection (knock on wood). Feel free to email about product info if you like.
kbtoys
we don't just work on the chest. the vein for the graft is often taken from the legs. the vein usually comes from the greater saphenous vein, but with the prep that RockieSis mentions, you can also use the lesser saphenous vein. we only prep the back of the leg when the lesser saphenous is taken. the radial artery can also be used as a vein graft. and I have heard of taking the gastric artery, but have never seen it.
hope this helps you understand the complexcity of the prep
If its a planned cabg... the night before thier shaven and given a nice betadine scrub down, and then when in the OR we duraprep them from chin to toes, even arms just in case we take a vein. Works well and saves on time. full prep less than 5 minutes
on emerg cabg -alcohol and duraprep from chin to toes , both are then covered with ioban. works well .
zoe
marilynknowles
3 Posts
Please let me know your procedure your hospital is using to do your skin preps for open heart. What type of prep solutions you are using and how long do you prep for. Thanks