Reply To: care patients receiving thiotepa

  • Lisa Pinner

    Member
    June 24, 2021 at 11:43 am

    Hello,
    My answers are below in Purple . If you would like I can send the reference tool.
    1. frequent bath for 24 hours or 48 hours after thiotepa? During Thiotepa baths are every 6 hours up to 24 hours after the last dose.
    2. can use soap or just advise using warm water only ? We allow mild soap but no lotions especially in the diaper area  We do not allow CHG  or Theraworx during and for 24 hours post.  (our adult BMT team allows them to shower with hibiclens. 
    3. frequency of changing central line dressing during receiving thiotepa? can still use transparent dressing like opsite dressing for covering the wound ? or only gauze is recommended? We had a few problems with no dressing so we now allow the central line dressing but change it 24 hours after the Thiotepa is complete.  NO other tapes or adheasives

    Let me know if there is anything else I can help you with.
    Lisa

     

    Lisa A. Pinner, RN, MSN, CNS, CPON, BMTCN

    Stem Cell Transplant Clinical Nurse Specialist

    Lucile Packard Children’s Hospital Stanford/ Stanford Children’s Health

    725 Welch Road, Room 5280

    Office # (650) 497-8072 

    Cell Phone # (650) 407-9345

    lpinner@stanfordchildrens.org

     

    CONFIDENTIALITY NOTICE: This communication and any attachments may contain confidential or privileged information for the use by the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or the attachments is strictly prohibited. If you have received this communication in error, please contact me and destroy all copies of the communication and attachments. Thank you.

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    Original Message:
    Sent: 6/24/2021 11:29:00 AM
    From: Mary Lynn Rae
    Subject: RE: care patients receiving thiotepa

    Hi–we are pretty much the same as Rady and Boston with the following exceptions….
    1. We do use mild foam soap in the baths (Q6 hours) but no CHG
    2. We wait 7 days until resuming CHG bathing and no issues with that
    3. We continue to clean the CVC site with CHG Prevantics but do not place BioPatch

    Mary Lynn
    Mary Lynn Rae, MSN, RN, CPHON, NPD-BC
    NPD Practitioner/Clinical Educator:  Hem/Onc/SCT (LC17/LC18)
    Ann & Robert H. Lurie Children’s Hospital of Chicago
    225 E. Chicago Avenue
    Chicago, Illinois  60611
    Phone:  312-227-4224
    Pager:  312-227-4000, ask for pager 74224
    email:  mlrae@luriechildrens.org

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    Original Message:
    Sent: 6/24/2021 7:41:00 AM
    From: Caroline Costello
    Subject: RE: care patients receiving thiotepa

    Hello,
    My answers are below in red. If you would like I can send the reference tool.
    1. frequent bath for 24 hours or 48 hours after thiotepa? During Thiotepa baths are every 6 hours up to 24 hours after the last dose.
    2. can use soap or just advise using warm water only ? Water only, no soaps, creams, or lotions. Also, no CHG baths until Day +21. They shower, we don’t rub the skin during the bath.
    3. frequency of changing central line dressing during receiving thiotepa? can still use transparent dressing like opsite dressing for covering the wound ? or only gauze is recommended?  No tape or occlusive dressings, clean with sterile water and use small 2×2 gauze with a mesh over it to keep secure. 

    Sometimes ever with all of this we still have patients who have burns.

    Let me know if there is anything else I can help you with.

    Caroline

    ——————————
    Caroline Costello RN, MBA, CPON, BMTCN
    Nursing Clinical Education Coordinator
    Boston Children’s Hospital
    caroline.costello@childrens.harvard.edu
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    ——————————————-
    Original Message:
    Sent: 06-23-2021 11:23 PM
    From: Wingsze Kong
    Subject: care patients receiving thiotepa

    hi all,

    We currently experienced a HSCT patient with severe skin burn reaction after 20 days of stem cell infusion. The doctors questioned the cause of the skin condition might caused by the thiotepa which gave in the conditioning protocol. Our institution only advice patients bath 2/ day for 24 hours after thiotepa, but do not have any guidelines or worksheet to follow. Therefore, I would like to ask is anyone willing to share their hospitals standards for caring patients receiving thiotepa? also I have some questions about caring patients receiving thiotepa:
    1. frequent bath for 24 hours or 48 hours after thiotepa?
    2. can use soap or just advise using warm water only ?
    3. frequency of changing central line dressing during receiving thiotepa? can still use transparent dressing like opsite dressing for covering the wound ? or only gauze is recommended?

    Thank you very much.

    Wing sze Kong
    Hong Kong Children’s Hospital