Non Ent Or Fires/caution With Chlorhex

[BIS40]

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ALWAYS HERE about ENT FIRES.....HAD TWO NON ENT IM SHARING JUST FOR KNOWLEDGE. 1ST AS CA2, DID BOWEL PERF ON CALL, SURGEON OPENED WITH BOVI.....POOF, POP AND FLAMES...EVERYONE LOOKED AT EACH OTHER AND SAID OH %^&*. METHANE IGNITED...NO HARM TO PATIENT, BUT I HAD MY ATTENDING RELIEVE ME WHILE I CHANGED MY SOILED PANTIES..............

#2.......CAREFUL with chlorhexedine. just finishing my peds fellowship, simple circ with fast surgeon. heard him use the $%^# thats hot, looked at melted gloves and blue or towel with flames like a pu pu platter...........no harm, but hes so quick that chlorhex is alcohol based and if you dont let it dry........guess what. almost had a weeny roast (i thought that was funny.....circ plus fire) anyway, learn from this....let that crap dry if you use it and start fast. (and put out that cigarette in the or)

 

[coprolalia]

1) You're not supposed to use chlorhexidine on neonates.

2) As you point out, it's the isopropyl alcohol that the chlorhexidine is dissolved in, not the chlorhexidine itself, that is the problem. That crap's like 40% isopropyl alcohol.

-copro

 

[urge]

1) You're not supposed to use chlorhexidine on neonates.


-copro

Why is that, cop?

 

[coprolalia]

Why is that, cop?

Sensitive skin = contact dermatitis. I think it's probably the isopropyl alcohol, though, and not actually the chlorhexidine. Most swab sticks have 40% isopropanol. Some have up to 70%. Also, the 5% chlorhexidine does seem to be more problematic (say, as compared to the 0.25% wipes).

Clearly a bit controversial, and I've seen it used. But, it is not "standard practice" in our NICU.

-copro

 

[BIS40]

thanks for input.......yes this is truw, because of alcohol content absorption, not on neonates, but routine short cases like circs where kids are bigger, great quick prep......just flammable, all im saying

 

[urge]

Sensitive skin = contact dermatitis. I think it's probably the isopropyl alcohol, though, and not actually the chlorhexidine. Most swab sticks have 40% isopropanol. Some have up to 70%. Also, the 5% chlorhexidine does seem to be more problematic (say, as compared to the 0.25% wipes).

Clearly a bit controversial, and I've seen it used. But, it is not "standard practice" in our NICU.

-copro

Thanks! But aren't the regular alcohol wipes 70% isopropyl? I see everybody using them.

 

[coprolalia]

Thanks! But aren't the regular alcohol wipes 70% isopropyl? I see everybody using them.

Yes. Good point.

The studies that showed contact dermatitis were the ones that had chlrohex impregnated into central line dressings meant to remain in contact with the neonates skin (as a barrier to infection). Apparently that's good enough for the pediatric folks to avoid it.

But, if you've seen a neonates skin, especially a tiny preemie, I can understand why you'd want to avoid stuff that is "harsh" to their little bodies.

-copro