Hi there this is Tammy and today we're looking at antiseptic swabs. We have many
to choose from but the question is which one do I use when, and wh. What is
informing your practice when you choose to grab one of the small waves versus
one of the sticks or the swabs. Well we're going to talk about that right
after this. Welcome back my name is Tammy and this is NurseMinder and on this
channel we do everything nursing so if you're new here consider subscribing
below so that you get the next video when it's release. So we have a variety
of options and that's because we have a variety of procedures that we're doing
for our patients that require us to know which one to grab and why. We'll take the
Loris alcohol pad here first because we often use this one in clinical
settings - for starting IVs for cleaning sites for blood draws etc. I've tried to
find out what size of an area this swab would be most effective in with its
antiseptic properties and I cannot find any research that tells me that, so if
you have any insight please put it in the comments to share so that we can be
better together. Sticking with the small wipes we're
going to go to the chlorhexidine this is a product by 3M and what's interesting
is 3M has a fantastic website and it talks about their products and it gives
you some very definitive information. For example, I have an application time of 30
seconds for a dry site or a 2-minute application time for a moist site.
Further on the lower half I have these small swab and it tells me it's good for
a 6 by 7 centimeter area. So we're gonna take a look at what that looks like in
practice. So beside my arm is a 6 by 7 dressing this would be the area size
that our chlorhexidine, and most likely our alcohol swab, would be most effective
in. If you were to take your alcohol swab and clean the entire length of this arm
we can see that in fact this arm is larger than the dressing size and I
may not have the best disinfectant antiseptic skin prep possible. So instead
we really want to just focus on this small area. Okay. Which is essentially the
size of the back of my hand. I am goining take our swab and you can go in a back
and forth motion or you can do circles, but you really want to get a 30-second
scrub to maximize that antiseptic property. Let it air dry and we are good
to go. In moving up to the small swab I have a 10 by 11 centimeter area that I
can clean with this product. So what I have here next is a cut out of a 10 by
11 centimeter area. If I were to place my arm in this area you can see that I have
about the third to a half of my arm that I can cover with my swab stick; from my
elbow down it's the upper half of my forearm. From my wrist up it'll be the
lower half of my forearm and considerable edges there as well before
I hit those borders.
So taking out our small swap stick we can then go ahead and clean. Remember we
need a 30-second scrub so that means we can go back and forth in one direction
for 15 seconds, and then flip it and do side to side for another 15 seconds. The
mechanical action is critical to help remove and reduce microorganisms on the
skin tissue. So let's talk about this green package. This is the mystery one
for me so this is a chlorhexidine swab minus the alcohol Zero alcohol in this
one. Okay. and that's an important distinction from the red package - this
one has alcohol - no alcohol. Now the difference here is the surface area. Even
though this is the same size swab as my chlorhexidine with alcohol, the surface
area here reverts back down to that five to six centimeters. In addition, if I'm
using a dry area 30 seconds scrub is okay but if I'm working on a moist area
I need to do a full 4-minute scrub for this to be effective. Again another
question I had when looking at these two products in particular was I noticed on
the green package it says not sterile but the red package doesn't say sterile
or not sterile there's just simply no claim here. So I did just a little bit
more research on this. The information I was able to find indicates that we
cannot guarantee that this is a sterile swab and therefore it should not be put
into your sterile field. And the third swab I want to talk about today is a
Povidone-iodine prep pad. This is another powerful antiseptic that is used
in the clinical setting. Again I was unable to locate information on its
surface area but I did find some rather important clinical considerations in
choosing between alcohol, chlorhexidine, and Povidone-Iodine doing iodine so let's look at
that next. So when it comes to the Povidone-iodine
solutions there are definitely some clinical considerations that we need to
think about before we use this as a treatment method as well. The first one
is do they have any thyroid issues - because there is iodine in here and this
iodine will be absorbed through the skin, through the wound - if you're using it to
clean the meatus it will also be absorbed that way as well and it can
cause issues with our thyroid levels. The second one is for women who are
considering conceiving or they are pregnant, this iodine can actually cause
problems with the fetus itself or with the sperm that are trying to impregnate
the ova. And the third one is if patients are on lithium we want to monitor them
and make sure that we choose maybe an alternate method because there is some
contraindications with taking lithium and using povidone-iodine.
Now the alcohol swab also might impact your blood glucose readings. There is
some mixed research regarding this and the research involves - and the research
revolves around whether they first drop or second drop would be a better, more
accurate reading of a patient's blood glucose. In 2017 Foos conducted a study
and found that if the blood did not form a round drop that there was significant
alcohol dilution in the blood sample. She also found that between drop one and
drop two there was not a clinically significant change in the blood glucose
reading. In terms of determining your patient's blood alcohol level, the
alcohol pads were found to not cause any impact to the actual blood alcohol level
of your patient. Now you'll want to check with your agency to confirm their policy
as to how they want you to proceed using these items. So today's video came from a
question of "what does inform your practice"? I was curious about some of
these swabs and these pads and I hope that this has helped you as well in your
practice. If you've got some other information please share it below in the
comments because together, we're stronger and until next time - Make it a great day :)