Well, let's see here although i find this subject to be a no-brainer, you are right, it is hard to find a study using the word "brief", there are multitudes of studies that use the word prep and wash wherein ALL have determined alcohol as discussed was effective. Every medical text and nursing text that I could locate refers to "preping" the injection site with alcohol. I mean, at what point is this just a given, are all these people blowing it out their butts? In the case of prevention of infection, it would seem to me that one should err on the side of safety and there is enough material out there to, if not prove, at least introduce a reasonable certainty that you are better of to swab than not to swab! I think advising members at large to skip the alcohol prep and just inject is just plain negligent! Oh, and i learned something here, as a poster above pointed out, it seems that 70% alcohol is more effective than 95%! Go figure. Just to reiterate, there is NO question that isopropyl alcohol is an effective disinfectant, if youwant to be safer, just rub longer!
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Referencing the full text we see that the site was preped by swabing briefly three times and allowed to dry.
J Clin Microbiol 2002 May;40(5):1660-5 Related Articles, Links
Comparison of four antiseptic preparations for skin in the prevention of contamination of percutaneously drawn blood cultures: a randomized trial.
Calfee DP, Farr BM.
Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA.
A number of skin antiseptics have been used to prevent the contamination of blood cultures, but the comparative efficacies of these agents have not been extensively evaluated. We therefore sought to compare the efficacy of four skin antiseptics in preventing blood culture contamination in a randomized, crossover, investigator-blinded study conducted in an emergency department and the inpatient wards of a university hospital. The patient group included all patients from whom blood samples were obtained percutaneously for culture. Skin antisepsis was performed with 10% povidone-iodine, 70% isopropyl alcohol, tincture of iodine, or povidone-iodine with 70% ethyl alcohol (i.e., Persist). The blood culture contamination rate associated with each antiseptic was then determined. A total of 333 (2.62%) of 12,692 blood cultures were contaminated during the study period compared to 413 (3.21%) of 12,859 blood cultures obtained during the previous 12-month period (relative risk = 0.82; 95% confidence interval, 0.71 to 0.94; P = 0.006). During the study, the contamination rates were determined to be 2.93% with povidone-iodine, 2.58% with tincture of iodine, 2.50% with isopropyl alcohol, and 2.46% with Persist (P = 0.62). We detected no significant differences in the blood culture contamination rates among these four antiseptics, although there was some evidence suggesting greater efficacy among the alcohol-containing antiseptics. Among the evaluated antiseptics, isopropyl alcohol may be the optimal antiseptic for use prior to obtaining blood for culture, given its convenience, low cost, and tolerability.
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LDA J 1997 Fall;56(3):16-8 Related Articles, Links
Efficacy of topical disinfectants.
Oeschger MP, Hubar JS, Cresson RJ.
Department of Microbiology, Immunology and Parasitology, Louisiana State University Medical Center, New Orleans 70119, USA.
A comparison of bactericidal activity of two surface disinfectants showed that both were highly effective. The glutaraldehyde-based disinfectant showed higher efficacy on roughed surfaces than the alcohol-based disinfectant. The study used a novel, and generally applicable, method to evaluate the surface killing potential of disinfectants
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http://nursing.about.com/c/ht/01/08/How_Administer_Intradermal_Injection0997231775.htm
How to Administer an Intradermal Injection
From your Nursing Guide
"....5. Cleanse area with an alcohol swab, wiping with firm pressure from injection site outward in a circular motion. Allow skin to dry.
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http://www.engenderhealth.org/ip/aseptic/at4.html
Introduction to aseptic procedures:
Client prep for clinical procedures
"...Before giving an injection:
Wipe the client's skin at the intended injection site with an antiseptic solution to minimize the number of microorganisms and reduce the risk of infection.
If there is visible dirt, wash the injection site with soap and water.
Using a fresh swab, wipe the site with an antiseptic, wiping in a circular motion from the center outward.
If alcohol is used, allow the alcohol to dry in order for maximum effectiveness in reducing microorganisms. "
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http://216.239.37.100/search?q=cach...t14.pdf+alcohol+prep+injection&hl=en&ie=UTF-8
Procedure for Insulin Administration by Injection
"...10. Prop syringe on the cap in a "clean field" Select the site to be used and prep with alcohol and let dry..."
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http://216.239.37.100/search?q=cach...ule.pdf+alcohol+prep+injection&hl=en&ie=UTF-8
State f Maine, EMT Training Module
"...4. Prepare the site with an alcohol prep"
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http://www.medtrng.com/blackboard/administer_intra.htm
Excerpt from an army Medic Training manual
Administer Intra-muscular, Subcutaneous and Intra-dermal Injections
"...(10) Cleanse the injection site with an alcohol prep pad, beginning in the center of the site and with a circular motion, clean outward approximately 3 inches"
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Administer Intra-muscular, Subcutaneous and Intra-dermal Injections
Wilderness Emergency Medical Training Site
"... 6: alcohol prep pads, in foil"
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SofaGeorge said:
And again I point out... we are talking alcohol wipes... not disinfecting the skin with 70% isopropyl solution and iodine.
If you think alcohol wipes are so effective... use one on your hands and then operate.
Rubbing a tiny swab of alcohol across your skin before you stab in a needle doesn't do jack shit.
Please reference one site on Medlars or Medline that praises efficacy of a brief alcohol swab prior to giving an injection for disinfecting the surface area. You will find that it is highly inefective... to the point of being a joke. You can find PLENTY of references to alcohol being used to kill bugs and germs. Bleach kills bugs and germs too. So does Non11 and 9. You can soak plenty of bug in alcohol and kill them. That doesn't have much to do with rubbing a small pad across the skin for a second or two.
Do you want to use alcohol swabs to disinfect the skin prior to injection? Sure... it can be done. It will take you about 10 minutes. Do you know anyone who swabs more then a wipe or two?
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This thread is so idiotic it makes me sick...you are an idiot ...
