![]() If intravenous administration sets are used to infuse lipid-containing solutions, medications like TPN or propofol, the sets should be exchanged every 24 hours. Recommendations also include changing the intravenous administration set every 96 hours. It is also advisable to disinfect injection ports, needless connectors, and catheter hubs with either 70% alcohol or chlorhexidine swabs before use. However, if the dressing has a break in the seal or becomes visibly soiled, it should be changed. Dressing changes for central lines should occur every 5 to 7 days with a transparent dressing or every two days with a gauze dressing. A daily inspection should ensure that the line is properly in place, free from infection, and in working order. Routine inspection of the central line, regardless of location, should be performed daily. Īfter insertion, any manipulation or use of the catheter should take place only after standard hand hygiene and clean glove practices. After competition of the procedure, a sterile dressing should be applied over the insertion site before using the line. Furthermore, appropriate skin preparation with 0.5% chlorhexidine is preferable to povidone-iodine or 70% alcohol as a means to decrease the skin flora and reduce catheter-based infections, unless the patient has an allergy to chlorhexidine. Using sterile precautions, sterile drapes, sterile gowns, and gloves will help minimize contamination of the catheter during the insertion phase. ĭuring initial central line placement, the use of soap and water or alcohol-based scrubs should standard before donning sterile gloves. However, if there is a need to maintain critical venous access to maintain the stability of the patient, then the line should be utilized until another working site of access is available. In the event of insertion site infection, decreased functionality, or new bacteremia, the catheter should be removed. After insertion, there is no contraindication to routine catheter maintenance and care. It is worth noting that one should avoid insertion sites with known indwelling intravascular hardware this would include permanent hemodialysis catheters or pacemaker leads. Other relative contraindications include site-specific considerations. If possible, correction of the underlying coagulopathy or thrombocytopenia should occur first however, this sometimes is not a viable option in an unstable patient. However, bleeding post insertion is uncommon moderate-to-severe coagulopathy before initial placement is a relative contraindication. There are few relative contraindications to standard central line insertion. ![]()
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