Brain Ventricle Shunt Infection
Brain Ventricle Shunt Infection
Changing the Central Line Dressing Keeping the skin clean and changing the dressing as ordered may help to prevent infection. How often you need to change the dressing will depend on a few things. You will always change the dressing at least 1 time each week. If the dressing is wet, loose, or dirty, change it right away. You or someone in your family can learn how to do this. Others have a nurse come in to help with this care. Gather supplies and place them on a clean work space. You will need sterile gloves, chlorhexidine swab sticks, tape, and sterile dressings. Always wash hands well with soap and water before touching the catheter line. This will help to avoid spreading germs. Wear a mask when changing the dressing. Also, have the patient wear a mask or keep the head turned away while the dressing is being changed. You may want to wear gloves when taking off the old dressing. Take off the old dressing. Avoid using scissors or sharp tools. They could cut the catheter. Do not pull on the central line catheter when taking off the dressing. Check the site for swelling, drainage, or redness. Wash hands again. Put on sterile gloves. Wash site with a chlorhexidine swab using a circular motion for 30 seconds. Start at the exit site, wash the catheter, and wash away from the site. Let the cleaned area air dry for at least 30 seconds. Some doctors will order a small disc that will help prevent infection. Put the disc around the catheter where it comes out of the skin. The colored side should be facing away from the skin. Lay the catheter on the skin in a loose circle if it is long, or in a straight line if it is short. It should not lay on top of where the catheter goes into the skin or lay on itself. Put the dressing snugly on all sides of the catheter. Most dressings are clear and will stick to the skin. If it is not sticking, put medical tape on the edges only to hold it in place. Throw away the old dressing and used swabs and wipes. Remove gloves. Wash your hands with soap and water. Flushing the Catheter The catheter line should be flushed each day with a sterile fluid. It should also be flushed after each use. This will help keep the line from getting blocked. Gather supplies and place them on a clean work space. You will need rubbing alcohol with cotton balls or wipes. You will also need a 10 mL syringe filled with the fluid to flush the catheter. Your doctor may order heparin or normal saline for you to use. You may need more supplies if you have more than one opening to flush. Your doctor may have you use a smaller amount of fluid to flush the line if the catheter is in a child. Wash your hands with soap and water. Scrub the cap for at least 15 seconds with a rubbing alcohol wipe on the top and sides and let dry. Remove the end cap from the syringe and check for air bubbles. Slowly push the syringe plunger forward until all the air is out of the syringe. Screw the syringe onto the end of the cap that covers your catheter line. Unclamp the catheter and inject the flush into the catheter. Flush slowly and steadily until the syringe is empty. Remove the syringe from the catheter. Throw away into a container designed for used syringes. This is called a biohazard container. Do not throw away syringes in the trash. If the catheter has many lumens, repeat for each lumen. Use new supplies for each lumen. Do not reuse the same syringe. Throw out any used swabs, wipes, or materials. Wash your hands with soap and water. Changing the Injection Cap Gather supplies and place them on a clean workspace. You will need a sterile injection cap for each catheter lumen. You will also need a syringe of fluid for each injection cap. Wash your hands with soap and water. Remove the new injection cap from the package without touching the ends. Connect the syringe of fluid to the end of the injection cap. Hold the syringe so the cap points up and prime the cap with the fluid. Tap the cap gently to get rid of any air bubbles and leave the syringe joined to the cap. Clamp the catheter line and remove the old cap. Scrub the end of the catheter for at least 15 seconds with alcohol and let air dry. Remove the sterile tip protector from the new cap. Screw the new cap onto the catheter connector and remove the syringe from the cap. Throw out any used swabs, wipes, or materials. Wash your hands with soap and water. Special Precautions Avoid contact sports or rough play. Keep sharp objects away from the catheter. Avoid swimming in ponds, lakes, rivers, ocean, or hot tubs. Keep the dressing covered when bathing. Change the dressing if it gets wet, dirty, or becomes loose. Help keep the catheter in place by wearing clothing that fits snugly against the body. Keep the catheter clamped when it is exposed to air. For example, when connecting an IV or when the cap is being changed. Your doctor will teach you when and how to clamp your catheter the right way. Make sure to check the line every day for signs of infection.
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