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SITE CARE
The care and maintenance of the catheter requires well-trained, skilled
personnel following a detailed protocol. Catheter is compatible with ointments.
CATHETER LUER DISINFECTION:
appropriate antiseptic after cap is removed and before accessing. Perform
every time catheter is accessed or disconnected.
WARNING: Do not use acetone on any part of the catheter tubing. Chlorhexidine
is the preferred alternative.
Aqueous based povidone iodine (Betadine™*), dilute aqueous so-
dium hypochlorite solution (Anasept™*), chlorhexidine gluconate 4%
(Hibiclens™*, Betasept™*), and Bacitracin zinc ointment (Neosporin™*) are
the recommended antiseptic agents to be used with this catheter.
Clean the skin around catheter. Cover the exit site with occlusive
dressing and leave extensions, luers, and caps exposed for access by dialysis
staff. Wound dressings must be kept clean and dry. Patients must not swim,
shower, or soak dressing while bathing unless instructed by a physician.
Should the adhesion of the dressing become compromised due to moisture
from profuse perspiration or other inadvertent wetting, the dressing must be
changed under sterile conditions by the medical or nursing staff.
CATHETER PERFORMANCE CAUTION
Lumen obstruction is usually evident by failure to aspirate blood from the
lumen, inadequate blood flow and/or high resistance pressures during
hemodialysis. The causes may include inadequate catheter tip position,
catheter kink and clot. One of the following may resolve the obstruction:
•
Verify the clamps are in open position when attempting to aspirate.
•
Reposition patient. Have patient cough.
•
Provided there is no resistance, attempt to open or move the tip by
vigorously flushing the catheter with sterile normal saline.
•
If thrombus develops in either lumen, first attempt to aspirate the clot
with a syringe. If aspiration fails, the physician may consider using a
thrombus dissolving solution (i.e. TPA) to dissolve the clot. Excessive
force should not be used to flush an obstructed lumen.
INFECTION
Catheter related infection is a serious concern of indwelling catheters. Sterile
technique should always be strictly adhered to. Clinically recognized infection
at a catheter exit site should be treated promptly with the appropriate antibi-
otic therapy.
Per CDC Guidelines for the Prevention of Intravascular Catheter-Related
Infections:
•
Use maximal sterile barrier precautions, including the use of a cap,
mask, sterile gown, sterile gloves, and a sterile full body drape, for the
insertion of central venous catheters.
•
Before central venous catheter insertion, prepare clean skin with a >0.5%
chlorhexidine preparation with alcohol. If there is a contraindication
to chlorhexidine, tincture of iodine, an iodophor, or 70% alcohol can be
used as alternatives.
•
Antiseptics should be allowed to dry according to the manufacturer's
recommendation prior to placing the catheter.
•
After central venous catheter insertion, see SITE CARE for compatible
antiseptics.
Priming Volume Chart
Tip to Cuff Length
19cm
23cm
28cm
33cm
37cm
42cm
Lumen Volume
2.1cc
2.3cc
2.5cc
2.6cc
2.8cc
3.2cc
Scrub catheter luers with an
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