A 37-Year-Old Man Is Brought to the Emergency Department Following

question 224

Multiple Choice

A 37-year-old man is brought to the emergency department following a motor vehicle accident in which he was the unrestrained driver.  Paramedics report that his breath smelled of alcohol at the scene.  En route to the hospital, the patient receives 2 L intravenous normal saline.  In the emergency department, his blood pressure is 100/60 mm Hg, pulse is 130/min, and respirations are 44/min.  He is admitted directly to the intensive care unit, where he is intubated and placed on mechanical ventilation.  A decision is made to insert a central venous catheter.  In addition to sterile draping during the procedure, which of the following actions would be most likely to prevent intravascular catheter-related infections?

• A)Alcohol-based hand scrub prior to beginning the procedure
• B)Daily application of topical mupirocin at the catheter site
• C)Insertion of the catheter in the femoral vein
• D)One dose of intravenous vancomycin prior to catheter insertion
• E)Replacement of the catheter every 7 days

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