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Second Opinions > preps

preps

what are you using instead of betadine for patients with a iodine allergy for cataracts?

Started by: Mary Forman (OR Manager/Supervisor) at April 9, 2010 (7:52 am)

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We do a skin patch test on the patient to see if they tolerate the betadine prep. More often then not, they do not react to the betadine prep.
If they cannot tolerate betadine we carefully wipe the eyelid skin with alcohol and put two drops of Zymar in the eye before we drap.
We also verify that they do not have a shellfish allergy.

J. Solso (Director, Surgical Services/Director of Nursing) at May 12, 2010 (11:28 am) [last edited on May 12, 2010 (11:31 am)]

I also wanted to add: we verify that the patient does NOT have an allergy to ingesting shellfish. In this case we would not use iodine prep.

Blaney N. (Director, Surgical Services/Director of Nursing) at May 6, 2010 (3:30 pm)

In the past, we have actually used baby shampoo mixed with sterile water as the prep soap. About 5 years ago, we began to stray from the use of baby shampoo because of its undocumented antimicrobial qualities (we did not ever have an issue with infection though). Now we use hibiclens mixed with sterile water as the prep. The hibiclens "drug facts" state that it may be used as a prep for surgery and says "Do not use.....in contact with the meninges" or "in the genital area". However, it does not say anything about the mucosa. It also states in the drug facts if the product does come into contact with the eyes, that it must be thoroughly rinsed...(which of course we do). Another note about patient's with betadine allergy: We clarify if the allergy is an IV allergy or a topical allergy; we have found that patient's list betadine/iodine allergy mostly because of IV iodine reactions. When this is the case we use the topical iodine and document that the patient stated it was an "IV allergy only, topical is OK".

Blaney N. (Director, Surgical Services/Director of Nursing) at May 4, 2010 (11:36 am)

Hibiclens and PCMX are not safe for mucous membranes and Technicare is no longer manufactured because it lacks FDA approval, so our facility is still looking for an alternative to betadine.

T. Whetstine (Other) at April 27, 2010 (6:50 pm)

Hibiclens is not safe for mucous membranes and Technicare is no longer manufactured because it lacks FDA approval, so our facility is still looking for an alternative to betadine.

T. Whetstine (Other) at April 27, 2010 (6:45 pm) [last edited on April 27, 2010 (6:49 pm)]

hibiclens

Hilare Klinger (Administrator/Director/Manager/Owner/Exec. Officer) at April 14, 2010 (10:44 am)

PCMX or Technicare are approved for use in opthalmic surgery.

Kimberly Klinkowski (Director, Surgical Services/Director of Nursing) at April 13, 2010 (1:14 pm)

http://www.outpatientsurgery.net/issues/2007/03/eye-preps-when-you-cant-use-povidone-iodine

dan oconnor (Other) at April 9, 2010 (3:05 pm)

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