Cleaning your IV site

[tcripp]

We use iodine and then alcohol for cleaning the IV site.

Just to clarify...iodine and then alcohol?

[PCP]

I just doubled checked in my IV refresher course book to make sure that I had it correct and yes, we cleanse the site with a povidone-iodine swab and then with an alcohol swab. Seems you folks down in the US use alcohol first then the iodine. Not sure if it makes any difference, but if it does I am curious to know why? Hope that did not come across as rude, as I am always up for learning and new ways of doing things.

Brian

[tcripp]

Hope that did not come across as rude, as I am always up for learning and new ways of doing things.

Brian

Brian, absolutely not in the least lttle bit. I'd like to understand why you guys do it one way and we might do it another. 98% of the reason I "sit on a forum" is to learn new things. It gives me a good starting point for research.

The reason this thread started? My ILS partner made a comment that she "always" cleans with alcohol and then iodine unless there is a known allergy. She couldn't tell me why, just that was they way she was taught.

For a simple IV start, I use alcohol unless the person is darker skinned and then I use the betadine to help me see the veins. (It's quite a neat trick if you've never tried that before.) For our blood draws, I use betadine but its not usually preceded by alcohol unless I need to make sure the skin was clean first.

So, I'll continue my research if you'll let me know why you do the betadine first.

[Just Plain Ruff]

When I'm using iodine or betadine for an IV start I'm going to swab the betadine and then alcohol.

UNLESS I'm drawing blood for a BAC (blood alcohol) and then it's strict betadine.

But I have always done betadine and then alcohol if i'm going to use betadine. No reason but it just seemed to be the right sequence.

[crotchitymedic1986]

Skin is skin, its not about a surgical procedure or IV starts, its about what is most aseptic. Just because we have always done it that way, doesnt make it right. Doctors were allowed to smoke in the OR back in the 50's, but we dont do that anymore. You can call me an idiot all you want, but I promise you that at some point in your career you will see a change in alcohol prep use for IVs. If alcohol were the bomb, then there would be no need to use Betadine for surgical incisions, spinal taps, or central line placement.

[Just Plain Ruff]

Skin is skin, its not about a surgical procedure or IV starts, its about what is most aseptic. Just because we have always done it that way, doesnt make it right. Doctors were allowed to smoke in the OR back in the 50's, but we dont do that anymore. You can call me an idiot all you want, but I promise you that at some point in your career you will see a change in alcohol prep use for IVs. If alcohol were the bomb, then there would be no need to use Betadine for surgical incisions, spinal taps, or central line placement.

I'm certainly not calling you an idiot, I have seen the change from alcohol to Chloraprep. It's what our service uses exclusively. In our IV start kits, there is no alcohol prep. It's not included based on the evidence that Chloraprep cleans skin better.

[crotchitymedic1986]

that was directed at dwayne, not you Ruff

[Just Plain Ruff]

that was directed at dwayne, not you Ruff

i know. I just wanted to say that I didn't disagree with your thoughts on this issue.

[PCP]

Brian, absolutely not in the least lttle bit. I'd like to understand why you guys do it one way and we might do it another. 98% of the reason I "sit on a forum" is to learn new things. It gives me a good starting point for research.

The reason this thread started? My ILS partner made a comment that she "always" cleans with alcohol and then iodine unless there is a known allergy. She couldn't tell me why, just that was they way she was taught.

For a simple IV start, I use alcohol unless the person is darker skinned and then I use the betadine to help me see the veins. (It's quite a neat trick if you've never tried that before.) For our blood draws, I use betadine but its not usually preceded by alcohol unless I need to make sure the skin was clean first.

So, I'll continue my research if you'll let me know why you do the betadine first.

Happy to see that you did not thing my comment was rude. You never know how people take it when they read a post, as it may come across as rude. As a Primary Care Paramedic, we do not draw blood, only start IVs. So my question is why only use betadine when drawing up blood?

Thank you for the tip. Next time I start a line on a patient with darker skin, I will attempt to only use iodine and see if that helps me see the veins better

I am going to ask a few of the other paramedics I work with as to why we use iodine first then alcohol. I am on the same page as your ILS, as I was taught in school to use idodine first then alcohol. I guess I should have asked the reason why?

I have one more question for you. What is the reason that you take vials of blood from your patient and how many vials do you take?

Thank you again for the great tip!

Brian

[tcripp]

Happy to see that you did not thing my comment was rude. You never know how people take it when they read a post, as it may come across as rude. As a Primary Care Paramedic, we do not draw blood, only start IVs. So my question is why only use betadine when drawing up blood? I was taught in school tto clean the site diligently...with alcohol. I don't recall the topic of betadine ever coming up. On Sunday, I have an ACLS renewal with the same instructors and plan to ask them about it then. The betadine is used on request of the hospital ESPECIALLY if we suspect infection.

Thank you for the tip. Next time I start a line on a patient with darker skin, I will attempt to only use iodine and see if that helps me see the veins better I've even found it helpful in those where the veins don't "pop", even on lighter skinned people. That blue vein under the yellow/orange is pretty good. Be sure to let me know what you think.

I am going to ask a few of the other paramedics I work with as to why we use iodine first then alcohol. I am on the same page as your ILS, as I was taught in school to use idodine first then alcohol. I guess I should have asked the reason why? If you get one other thing from me, always try to find out why you do something. I'm trying hard to do that now and catch up is, well, a b*tch. But, again, my ILS does it in reverse; alcohol then iodine.

I have one more question for you. What is the reason that you take vials of blood from your patient and how many vials do you take? We have a local hospital who has requested that we do it, when we can. Like IV's, if we can get one, they are thrilled. We take 4 vials which are supplied by them. It doesn't really take any extra time for us to do and it's one more skill I can maintain.

Thank you again for the great tip!

AND this is the reason I like the forums. So we can learn the little street tricks from each other!

Brian

My responses are imbedded in your quote, in bold/red.