Proper use of antiseptis in children

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Here is a list of the various skin conditions in childhood and recommendations in antiseptic products for use in paediatrics.


Infections of the child

Infections related to the care of the child


  • The principal infections are nosocomial. They depend on:
    • The prematurity of the child,
    • The hospitalisation in intensive care (immunosuppression),
    • Invasive procedures,
    • Continued parental feeding.
  • There are various modes of contamination :
    • Vascular catheterisation,
    • Mechanical ventilation,
    • Urinary or gastric probe.

Infection control

  • Disinfection of the hands by friction.
  • Limitation of invasive gestures.
  • Use of disinfectants.

Disinfectant and the child

The main care

  • Disinfection of the healthy skin.
  • Umbilical cord care.
  • Urinary probe on site and evacuation.
  • Disinfection of the surgical site in ophthalmology.
  • Care of the mouth.
  • Antisepsy of injured skin.

Risks

  • At the time of disinfectant treatments, the skin of the child is prone to several risks:
    • The local application covers too much body surface (30%),
    • The immaturity of the system of detoxication involves risks of toxicity;
    • The cutaneaous barrier is thin, there are risks of penetration of the products.

To choose the right disinfectant

  • The use of the following disinfectants in children is recommended:
      • Chlorhexidine and derivatives
      • Good antibacterian activity,
      • Low toxicity for the skin,
      • Weak irritation (- of 5%),
      • Do not put in contact with the eyes, the brain and the ear canal in the event of perforation of the tympanum
      • Avoid ready to use solutions: their disinfectant property is insufficient and contra-indicated on the mucous membranes,
    • Quarternary ammonium compounds
      • Detergent properties,
      • Antimicrobic activity with narrow spectrum,
      • Must imperatively be associated with chlorhexidine (do not use pure),
    • Chlorinated compounds
      • Products with a broad spectrum,
      • Often used in ocular antisepsy.
    • Iodised products and derivatives
      • Do not use on the umbilical cord and with children suffering from hyperthyroidism (involves a thyroid atrophy),
    • Alcohols
      • Increase the effectiveness of other disinfectants,
      • Local anaesthetic effect,
      • Broad spectrum and fast activity,
      • Supports the drying of the product on the skin.
      • Risks of high-dose intoxication, not to use on the mucous membranes.

Precautions for use

  • Conservation :
    • Safe from heat and the light,
    • Check the seal
    • Beware of the expiry date.
  • Use :
    • Preferably use products of the same family for a care,
    • Dilute soaps and mouthwashes,
    • Beware of the concentrations and duration of contact,
    • Supervise tolerance,
    • Choose unidose systems,
    • Rinse with sterile water after 30 seconds action with a premature child, to avoid irritations,
    • The application must be short in duration and localised.

Sources


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