Course Access
Hi Lesley,
Our facility has used a 1% CHG in 75% ethanol skin prep for epidurals
for quite a number of years without incident. However we reviewed this
earlier this year following an article in the journal Anaesthesia News
titled ‘The Truth, The Whole Truth” (available at the following
website):
http://www.aagbi.org/publications/anaesthesia_news/2010/feb2010.pdf
We were not able to find any guidelines clearly specifying the strength
for epidural skin prep. However an e-letter discussion sparked by the
following article was helpful.
T. M. Cook, D. Counsell, and J. A. W. Wildsmith Major complications of
central neuraxial block: report on the Third National Audit Project of
the Royal College of Anaesthetists Br. J. Anaesth. (2009) 102(2):
179-190 first published online January 12, 2009 doi:10.1093/bja/aen360
After a lengthy investigation and multidisciplinary review it was agreed
to continue using the current skin prep. I am happy to discuss this
offline if you want further information.
Regards,
Fiona De Sousa
Infection Prevention & Control Coordinator, SAH
02 9487 9732
—–Original Message—–
Behalf Of Lesley Lewis
insertion
Can someone please direct me to any documentation guiding the most
appropriate strength of chlorhexidine for skin disinfection prior to
epidural insertion.
I am reviewing a request to use 0.5% chlorhexidene in 70% alcohol to
minimise any risk from residual chlorhexidene being transmitted on the
needle to the meninges. While there is information available for
prevention of catheter related bloodstream infections my lit search has
not found anything specifying the ideal strength for epidural insertion.
thanks Lesley Lewis
Regional Infection Control Consultant
Hume Region Infection Control Resosurce and Consulting Service
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