Wound Irrigation: Pre-procedure (Nursing)

00:04 Hi, guys, welcome to the skill wound irrigation.

00:07 So there's a few instances that you may use this in your practice.

00:11 So the first one, just remember, we're irrigating because a lot of times a wound can be extra draining there's a lot of extra tissue.

00:19 We may irrigate it just to make sure we can assess the wound bed more accurately.

00:24 Also, it's pretty typical to irrigate a wound before a dressing change.

00:29 And we definitely irrigate or cleanse the wound before obtain a wound culture.

00:34 So now let's take a look at what we're going to need.

00:36 We need a basin to catch all of the irrigation fluid, and of course and get a little bit messy, so we're going to need absorbent pad.

00:44 So just depending on the size of the wound, we definitely want to consider PPE that's appropriate.

00:50 Now, of course, irrigation solutions are going to vary depending on the physician order.

00:55 Sterile normal saline is a really common irrigation solution.

01:00 And of course, some sort of container to pull it in.

01:03 And we're also going to need a device to actually irrigate the wound.

01:07 Now if we're doing a dressing change, we may need a sterile dressing and sterile gauze may be indicated to help cleanse the wound.

01:14 So to start our procedure, of course, you want to perform your hand hygiene and provide privacy to your patient.

01:20 It's important to hear to explain the procedure.

01:24 Just know depending on the wound, some of these wounds are pretty big that we are dealing with.

01:29 When we irrigate or we cleanse it, there definitely could be some pain.

01:33 So we need to assess that as a nurse, and premedicate if at all possible.

01:38 And for appropriate body mechanics, make sure you raise the bed to an appropriate working height, and also assist the patient in a proper position.

01:47 Now we want to go ahead and put on gloves and this is a great time to put absorbent pad underneath the side you're going to irrigate and protect those linens.

01:56 Once we put the pad down, you want to put the basin under the wound as well.

02:01 This is what's going to catch all that irrigation fluid you're going to use.

02:06 Now if there's a dressing on the patient's wound, this is the time to go ahead and remove that old dressing that's soiled.

02:13 Get rid of that and remove your gloves.

02:16 We're going to perform our hand hygiene.

02:22 Hey guys, welcome to the live demo of wound irrigation.

02:26 Just know this skill is going to vary quite a bit depending if you're going to irrigate a pretty small wound versus a really big deep one.

02:34 And of course, it's going to be much easier to even irrigate maybe an arm wound versus one on the abdomen.

02:40 So seek out assistance if you need help with this.

02:43 So before we get started, let's look at our equipment.

02:46 A basin's going to be really great to catch all that irrigant fluid.

02:50 But of course, this is probably only going to be useful, if maybe you're irrigating a foot wound or maybe one on the arm for example.

02:58 And as you can imagine irrigation to get messy.

03:01 So make sure you bring absorbent pads because this can get all over the patient's linen.

03:06 Also, when we're irrigating depending on the severity of the wound, you want to consider your PPE.

03:12 Reason being is when we're irrigating, this could splash, so you may want to consider eye protection, for example, and of course gloves.

03:21 Now before we get much further, I want to talk about gloves.

03:24 So there's lots of evidence out there now that says that we do not have to use sterile gloves, but make sure you use your facilities policy.

03:33 So just keep that in mind.

03:35 Many general wound dressings now we use clean technique, but sterile supplies.

03:41 Now when I say sterile supplies, that means these things that are in the package.

03:45 So just pro tip for you.

03:48 Okay, the other thing to consider is your irrigation solution.

03:52 So this is going to be specifically ordered by your physician, it's important to make sure before you get started, you check that order.

04:00 And also another tip for you as a nursing student or a nurse.

04:03 When you talk about irrigation solution, many times we're going to use normal saline.

04:10 So just know, I don't know why we make this hard on you.

04:14 Usually you're not going to see the word normal saline on a bottle, what you're actually going to see is 0.9% sodium chloride, that is normal saline.

04:25 So if you're looking for it, look for the 0.9% sodium chloride that is our "normal saline".

04:30 And this is a really common irrigation solution.

04:34 Next we want a container to hold our irrigation solution, so we can pull it up with our catheter-tip syringe that we have here.

04:44 It's also a great idea to make sure that you have sterile gauze, for example.

04:49 So once you irrigate, a lot of times the wound bed can get or excuse me, the wound, the skin around it can get moist.

04:56 We don't want to leave that there.

04:58 We want to grab the gauze and and gently dry that skin.

05:02 And another pro tip when you go to irrigate, you're usually going to have to redo the dressing.

05:08 So save yourself a trip and bring all your sterile dressing supplies with you to the room.

05:14 Now let's go ahead and get started.

05:16 We want to perform our hand hygiene of course, and obviously provide privacy.

05:21 We want to explain this procedure to the patient thoroughly.

05:24 Because sometimes, this can be a little bit uncomfortable when you irrigate.

05:29 Think about you're putting a little bit of fluid in the wound, a little bit pressure.

05:34 So make sure you assess the patient's level of pain, and make sure you premedicate, if at all possible.

05:40 And of course, anytime you're working with a patient, if you can raise the bed to an appropriate working height.

05:47 Now positioning is important because depending if it's an arm and abdomen, maybe on the back of the coccyx, we're going to have to position the patient for ideal irrigation.

05:59 Now let's go ahead and put on our gloves.

06:09 Okay, so I'm going to put on my gloves.

06:11 And as you can see here with my model today, it's a little bit clearly not attached to a patient, but this is what we're going to work with.

06:18 We're going to place an absorbent pad underneath the wound.

06:22 Now if we can, and if it was a, maybe a foot wound or an arm or a leg, the basin will be great to catch all that irrigation fluid.

06:32 So when we go into the room, many times your wound is going to have a dressing over it.

06:37 So we're going to remove it at this time.

06:39 And then we're going to toss the soiled dressing and remove the old gloves.

06:44 So also, I want to note here, the previous shift was nice enough to date, time and also initial.

06:52 The reason why we like to do that is because we're going to know when the last time this dressing was changed.

06:59 And many times your order is going to let you know how often it needs to be changed.

07:03 For example, daily, maybe twice a day just depends on the wound, something that I hadn't removed that now.

07:17 Okay, I'm going to remove my dressing and I'm going to dispose of it.

07:21 And because I've touched a soiled dressing, I'm going to remove my gloves and perform hand hygiene again.