討論區

請教各位先進前輩~~

有關靜脈注射之皮膚消毒，所謂三消，是指Alc-BI(等30秒自然乾)-->75% Alc這樣的動作，做三次嗎? 或是75%Alc-->Alc-BI(等30秒自然乾)-->75% Alc

是否有相關文獻可以查詢呢?

http://www.documents.hps.scot.nhs.uk/hai/infection-control/publications/skin-disinfection-review.pdf

這個網站回應了您的問題

Summary
1. Little evidence to support the need for disinfection of the skin prior to any intradermal, subcutaneous or intramuscular injection.
2. If soiled, however, skin should be cleaned, based on basic commons standards, with soap and water.
3.If skin is visibly unsoiled and disinfection is still performed, according to decisions taken at local level to undertake this practice, care should be taken to disinfect the area properly with a pre-medicated 70% alcohol swab. The injection site should be cleaned for 30 seconds with an alcohol swab and allowed to dry for a further 30 seconds to ensure bacteria are rendered inactive and injections are given safely.

75%酒精等30秒二次是必要的(經實証明)BI是國內加強消毒效果

感謝學姊的回應~~

在學姊提供的資料中，注射部位僅使用酒精消毒即可嗎?

在疾病管制局｢侵入性醫療感染管制作業基準｣的第90章周邊靜脈注射中，僅提到使用70-75%酒精環狀消毒，待其乾燥達消毒效果，但沒提到需重覆2或3次以上動作。91章中央靜脈導管置放術中，提到使用優碘或碘酒環狀消毒停2分鐘，再使用酒精清洗消毒，同樣沒提到需重覆動作。

兩者之間差在碘的使用，是因為導管所導致的消毒差異嗎? 可以只用一個版本宣導臨床就好嗎?  至於重複2次或3次消毒動作，到底是否需要要求......學妹我還是不太瞭解，對於文獻實證上的強度，也不太會分辨，所以不知道該怎麼作才好....