Venipuncture - gauze vs cotton ball

Clovery · Mar 7, 2014

We don't even stock cotton balls... It seems like a pretty low risk but her rationale makes sense. We only use gauze.

SoldierNurse22, BSN, RN · Mar 7, 2014

We also don't carry cotton balls. I'd think the chances of that happening are slim, but I'd also bet it'd be pretty unpleasant for the unlucky patient who couldn't get their cotton ball out of their IV puncture site.

nurseprnRN, BSN, RN · Mar 7, 2014

Oh, for heaven's sake. Surely she doesn't think that malicious polyfiber (it's not really actual cotton, is it, right?) would, like, migrate, worm-like, through the puncture site (which is how big??) into the subq tissue ... Might it then creep along the capillary bed .... slide into a vein ... thence to wreak havoc systemically???? :eek: Run for the hills!

Ahem. I strongly doubt that even if a few fibers got stuck in the itty-bitty scab atop a venipuncture site that it would amount to anything serious, and in any case they would fall off with the scab. Seriously?

Am I the only one here who's old enough to remember Bandaids without Telfa sticking gauze threads to our skinned knees? No long-term effects, and those were much bigger scabs.

Use whatever is cheap and clean (no, it doesn't have to be sterile). Your instructor heard this old wive's tale somewhere, has never seen one iota of study to support it, but keeps repeating it because "it makes sense." No, it doesn't.

xoemmylouox, ASN, RN · Mar 12, 2014

Oh, for heaven's sake. Surely she doesn't think that malicious polyfiber (it's not really actual cotton, is it, right?) would, like, migrate, worm-like, through the puncture site (which is how big??) into the subq tissue ... Might it then creep along the capillary bed .... slide into a vein ... thence to wreak havoc systemically???? Run for the hills!

Ahem. I strongly doubt that even if a few fibers got stuck in the itty-bitty scab atop a venipuncture site that it would amount to anything serious, and in any case they would fall off with the scab. Seriously?

Am I the only one here who's old enough to remember Bandaids without Telfa sticking gauze threads to our skinned knees? No long-term effects, and those were much bigger scabs.

Use whatever is cheap and clean (no, it doesn't have to be sterile). Your instructor heard this old wive's tale somewhere, has never seen one iota of study to support it, but keeps repeating it because "it makes sense." No, it doesn't.

Thank god we still have some common sense left in this world. I have heard many absurd things in my career, but never about the dangerous/deadly cotton ball. My god think of the damage it could do..

ausrnurse · Mar 12, 2014

We stock "cotton balls" at my hospital - if you unravel them, they are a rolled up square of gauze!

BluegrassRN · Mar 12, 2014

Cotton balls come in a large container that is open for weeks/months. They are typically stored in smaller containers where they are exposed repeatedly to different hands and therefore germs. 2x2s are individually wrapped, and remain sterile until opened immediately prior to use. See where I'm going with this?

ILoveHealthCare · Mar 12, 2014

Cotton balls come in a large container that is open for weeks/months. They are typically stored in smaller containers where they are exposed repeatedly to different hands and therefore germs. 2x2s are individually wrapped and remain sterile until opened immediately prior to use. See where I'm going with this?[/quote']
Not all 2x2 are individually wrapped.

Clovery · Mar 12, 2014

I didn't think the nurse meant the cotton fibers could find their way into circulation - that's pretty ridiculous. But I do think it's possible (although probably unlikely) that a few stray fibers could get stuck under the skin as the site heals and possibly cause an abscess, like an embedded splinter would.

psu_213, BSN, RN · Mar 12, 2014

Not all 2x2 are individually wrapped.

You beat me to it. In our ER, we stock opened 2x2s in the carts in patient rooms with the phlebotomy/IV supplies, and this is what we use to provide pressure/tape down as a dressing for IV/blood draw sites. In the grand scheme of things, the infection risk is so infinitesimally low compared with other issues in the ER.

We do stock cotton balls with our ENT supplies--the most common use is to soak one in Afrin and shove it up the nostril(s) of someone with a nosebleed. What would happen if one of the fibers is aspirated????

nurseprnRN, BSN, RN · Mar 12, 2014

We do stock cotton balls with our ENT supplies--the most common use is to soak one in Afrin and shove it up the nostril(s) of someone with a nosebleed. What would happen if one of the fibers is aspirated????

Someday when things are quiet and you have nothing special to do, sit down c one of those "cotton" balls and pull it apart. Those are very long fibers. If they are getting all gelled up in a nice clotty nosebleed, it's not likely that any of them will make a break for it and scurry past the clot and down the clotty nasopharynx and, timing it perfectly, leap through the vocal cords and thence into the mainstem bronchus.

Shorter answer: Cough reflex.

psu_213, BSN, RN · Mar 13, 2014

Someday when things are quiet and you have nothing special to do, sit down c one of those "cotton" balls and pull it apart. Those are very long fibers. If they are getting all gelled up in a nice clotty nosebleed, it's not likely that any of them will make a break for it and scurry past the clot and down the clotty nasopharynx and, timing it perfectly, leap through the vocal cords and thence into the mainstem bronchus.

Shorter answer: Cough reflex.

I was being facetious.