Publicidad
Idiomas disponibles
Idiomas disponibles
4.
Carefully remove the old dressing, starting from the top of the dressing
and working downward. Remove the tape or dressing carefully to avoid
irritating your skin or pulling on the catheter.
Caution: Do not use scissors or any sharp-edged instruments as they
could damage the catheter.
5.
Wash your hands again.
6.
Carefully check the exit site and the skin around it. If you notice anything
unusual, finish the dressing procedure and then call your doctor.
7.
If you are instructed to use gloves, put on the pair of sterile gloves following
the procedure you were taught. After putting on the sterile gloves be careful
to not touch anything except the supplies being used for site care.
8.
Carefully clean the catheter exit site with an alcohol swabstick or sterile
cotton tipped applicator, soaked in hydrogen peroxide, starting at the exit
site and spiraling outward until a circle at least 8 cm in diameter has been
cleaned. Do not return to the catheter exit site with a swabstick that has
touched any skin away from the exit site.
9.
Repeat this step twice using the other two swabsticks. Look at the color of
the swabsticks after you have used them for signs of drainage.
10. Repeat step 8 using three of the povidone iodine swabsticks to clean the
same skin area again as well as the part of the catheter that will be lying on
the cleaned skin.
11. Gently clean the outside of the catheter with the inside surface of an alcohol
wipe, starting from the exit site to the catheter connector. You may hold the
catheter at the exit site with another alcohol wipe to prevent pulling on the
catheter. Do not pull on the catheter.
12. Allow the povidone iodine on the skin to air dry at least two minutes.
13. Apply a small amount of povidone iodine ointment to the exit site (optional).
14. Place the pre-cut gauze dressing over the ointment at the exit site, fitting it
snugly around the catheter. Place the 2 in. x 2 in. (5 cm x 5 cm) gauze over
the pre-cut gauze and catheter.
15. Apply the cover dressing (tape or transparent dressing) following the
directions in the package as well as instructions from your doctor or nurse.
16. Coil the catheter, check to see that it is not kinked or pinched, and secure it
to the chest or dressing with tape. This will prevent pulling of the catheter at
the exit site and decrease irritation.
17. Always secure the catheter in such a way that you can easily see the cap
end. Your doctor or nurse will help you select the best method to secure the
catheter. The type of clothing and normal activity will need to be considered
in this selection. You should periodically look at the capped end to be sure it
is undamaged.
18. During all dressing changes, assess the external length of the catheter to
determine if the catheter has moved. Regularly confirm catheter placement,
tip location, patency (that the catheter can be flushed) and security of
dressing.
Clamping the Catheter
Selection of the catheter clamp is very important since the catheter is
vital to your care. The wrong clamp can damage the catheter. Follow
these three rules for clamping:
1.
Use only smooth-edged clamps.
2.
Always clamp the catheter over the reinforced clamping sleeve or tape
tab, as instructed by your nurse. Never clamp over the reinforced segment
directly adjacent to the connector. (Figure 3)
DO NOT CLAMP HERE
Figure 3: Clamp Warning
3.
Follow the directions of your doctor or nurse regarding when to clamp. Most
Hickman™ and Broviac™ catheters come with pre-attached clamps and
reinforced clamping sleeves. If you are not sure which type of clamp to use,
contact your health care provider.
When should you clamp?
Your doctor or nurse may instruct you to clamp your catheter whenever it is
not being used. The catheter is filled with heparin, a blood thinner to keep the
blood from clotting (known as "heparin lock"), and is capped and will protect you
from having any problems, but the clamp can be another safety measure. You
should always clamp your catheter whenever it is opened to the air, such as
during catheter cap changes, or when connecting intravenous infusions to your
catheter. Always have a spare clamp available.
Flushing the Catheter and "Heparin Lock"
Procedure
Catheters are usually flushed (injected with fluid) at least once a day. Your
doctor may tell you to flush more or less frequently, so be sure to listen to
your doctor's instructions.
Supplies you will need:
•
Alcohol or povidone iodine wipe.
•
10ml syringe with attached 1 inch needle filled with 2.5 ml of heparin,
prepared for use
•
Clamp
•
Tape
The steps in the procedure are:
1.
Collect your supplies in a convenient place.
2.
Wash your hands thoroughly.
3.
Remove the tape that is around the injection cap.
4.
Clean the cap with an alcohol or povidone iodine wipe. If you use the
iodine wipe, allow the cap to air dry for two minutes – be sure not to
touch the cap during this time. Do not blow on the area or allow the
clean cap to dangle since this increases the chance of contamination of
the area with germs.
5.
Remove the needle cover and carefully insert the needle into the center
of the catheter injection cap.
6.
Release the clamp.
7.
Inject the heparin into the catheter. As you inject the last 0.5 ml of
heparin solution, withdraw the needle from the injection cap.
8.
Remove the needle from the injection cap. Discard the syringe and
needle in a biohazard container.
9.
Retape the cap as outlined in the injection cap change procedure. If you
have a multi-lumen catheter, use a separate syringe to flush each lumen
with sterile heparin solution. Your doctor or nurse will give you additional
information for the care of multi-lumen catheters. When not in use, your
catheter should be clamped.
Changing the Injection Cap
You should change the injection cap (connector) only if your doctor has
instructed you to do so and given you proper training. Injection caps are
typically changed every 3 to 7 days and can be done at the same time as a
dressing change.
Supplies you will need:
•
Sterile injection cap
•
Alcohol or povidone iodine wipe
•
Catheter clamp
•
Tape
The procedure to change the cap:
1.
Wash your hands thoroughly.
2.
Be sure the catheter is securely clamped over the reinforced sleeve or
tape tab.
3.
Open the package of the new injection cap and prepare according to
your instructions. Be sure the cap does not touch the outer surface of
the package.
NOTE: You may need to pre-fill the injection cap with heparin if it is a long
cap with significant air space. Your doctor or nurse will teach you this
additional procedure.
4.
Remove the old tape from around the cap by unpeeling the tape.
NEVER attempt to cut the tape with scissors as you may damage the
catheter.
5.
Using an alcohol or povidone iodine wipe, clean around the place where
the cap is connected to the catheter. Allow to air dry.
6.
While holding the catheter connector below the level of your heart,
unscrew the old cap and discard. (The fluid level in the catheter will drop
part-way into the catheter if the connector is held above the level of your
heart.)
7.
Pick up the new cap only by the top and remove the sterile tip protector.
Attach the new cap by firmly screwing it onto the catheter connector.
Make sure the cap is screwed on tightly to prevent leaking.
8.
Cut a 5 cm piece of tape and make tabs on each end by folding back
1 cm. Apply the sticky part of the tape around the connection of the cap
and catheter and fasten securely. Press ends of the tape together. The
tabs on the end of the tape will enable you to remove it very easily.
9.
Follow the directions your doctor or nurse has given you regarding
whether to leave the clamp in place.
3
Publicidad
