@AntoineBachy

https://clinicaltrials.gov/ct2/show/results/NCT00947518

We use chlorhexidine for extremely preterm babies and we use dakin for older ones but never had burns or any other problems for umbilical catheter insertion 

Hi!

We use  octenidine, unfortunately we only have access to a solution contaning alcohol - although an alcohol-free preparation is possible to produce via the pharmacy. We rarely see  necrosis and scarring (although reported in the literature).

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Posted June 10

 

 

Resuscitation:

·      Receive baby in sterile towel (pre-warmed) and place in plastic sheet (NeoWrap or household plastic wrap) on warmer (Giraffe Poptop) with a warming mattress in place and activated.  Our focus at delivery is on keeping the baby warm and limiting movement as much as possible, so a sterile thermal hat is also put in place.  

·     We use gel pad leads in micropreemie size for ECG (NeoTech Micro) and temp probe (Accutemp Plus), and velcro/cloth pulse oximeter probes  (LNCS NeoPT-3) Gel pads lose adhesion very quickly in humidiity, and probe positions are changed Q12 hours with cares

·      Lines are placed and respiratory support tubing is secured before lowering top of Giraffe to isolette position.  Humidity is added to 80%, and the ambient temperature is put on "skin" to keep skin temp at 36.5.

·      Once humidity is effective, plastic sheet is removed and infant is placed in supportive cotton wraps (Snuggle).  Linens are changed Q24 hours

·     UVC, UAC insertion using checklist; clean skin with chlorhexidine 2% without and rinse with sterile saline.

For 1^st72 hrs of life

·      Humidity in isolette: 80%.

·      No bath.

·      No tape except for ETT securement

·      Routine diaper care with water wipes.

·      Score skin health with a skin care score Q6 hours

        No weights, touch only Q6 hours or when necessary

·      Transition to PICC at 48 hours of life if no signs of infection.; If skin condition poor, keep UVC if in good position, until skin condition permits PICC (max 14 days).

We continue daily linen changes until PICC Is DC'd

We continue Q6 hour cares until approximately 32 weeks, or until infant is consistently uncomfortable more quickly

We are cleaning the skin with chlorhexidine 2% for the insertion of UVC /UAC in extreme premature neonates.

After cleaning let the skin dry for at least 30 seconds befor turning any light on the abdomen.

We have almost no leasions at the unit.

 

On 7/27/2018 at 5:26 AM, NICU RN 7 said:

clean skin with chlorhexidine 2% without

@NICU RN 7 thanks,  could you please clarify this sentence " clean skin with chlorhexidine 2% without" ?

We use chlorhexidine 0.05% solution for Umbilical lines and some PICC lines and take great care to ensure that the solution is only applied to the smallest area necessary and does not spill down the side of the baby and under their back.  We have rarely seen burns with this concentration.