Hemodialysis central venous catheter scrub – the -hub protocol … part 4

Central venous catheter 2

 

Antiseptic use and selection

As describe in  healthcare infection control practices advisory committee (HICPAC) guidelines for the prevention of intravascular catheter-related infections, prior to accessing the catheter hub it should be disinfected with an appropriate antiseptic (greater than 0.5% chlorhexidine with alcohol, 70% alcohol, or 10% povidone-iodine). There is not enough evidence to recommend one antiseptic over the others. Generally, antiseptics should be allowed to dry for maximal effect.

If using 70% alcohol, sterile antiseptic pads should be used (sterile pads are labeled sterile and packaging for non sterile pads often does not state whether the pads are sterile or non sterile). For practical reasons, pads or similar products might be preferred over other forms of antiseptics (eg swabsticks) for disinfecting the catheter as they are malleable and allow for vigorous cleaning of small spaces.

If using an antiseptic that leaves a residue (eg chlorhexidine), avoid allowing large amounts of antiseptic to enter the lumen of the catheter to avoid potential toxicities to the patient.

If using chlorhexidine, removing all blood residue is particularly important to maximise the effect of the antiseptic

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