Skin preparation—a collaborative effort
Two incidents have been reported to the College where aqueous chlorhexidine 2% with 4% isopropyl alcohol is suspected to have caused corneal injury. The NHMSFP Committee reminds all medical directors, surgeons and nurses of the November/December 2013 edition of the College Connector article regarding skin preparation. The following is a recap of that article.
Special care and attention must be taken to prevent injury such as chemical burns to a patient during surgical skin preparation, especially when prepping areas such as the face, eye and ears or mucous membranes.
Selecting an appropriate skin preparation is a collaborative effort, which requires both surgeons and perioperative nurses alike to be knowledgeable in the selection process, including awareness of any contraindications and/or special precautions. The surgical site prep solution should also be reviewed during the briefing period of the surgical safety checklist with all members of the surgical team present.
For more information regarding the contraindications and/or special precautions of this product, please refer to the manufacturer’s material data safety sheet.
Illicit drug users come from all socio-economic groups
One of the goals of the preoperative health history and evaluation is to identify any pre-existing condition(s) that may influence the patient’s response to anesthesia and surgery. Therefore, the pre-admission history must include a thorough medication history including:
- prescription medications
- non-prescription medications
- herbal medications and supplements
- alcohol and substance use (illicit, prescription) and abuse
Reminder to physicians who are preceptors to residents and fellows in non-hospital facilities
Medical directors are reminded that physicians who are preceptors to medical students, residents or fellows at a non-hospital facility must have privileges at the facility, and are held responsible for the medical care provided. Further, physician preceptors must be present in the operating room during any surgery performed by a resident and/or fellow.