Central Line Dressing Change

A central line (PICC, port, Hickman or other tunneled catheter) dressing change is a sterile procedure. Because of this, we strongly recommend that you receive training by a healthcare professional familiar with central line care and maintenance. There are many subtle ways a sterile surface can become contaminated, which puts you at risk for blood stream infections. These infections can be very serious, and even life threatening. The central line dressings should be changed a minimum of every seven days – every 48hr if gauze is used. If at any time the dressing peels, becomes wet underneath, becomes dirty, etc. it should be changed immediately. All components that can be changed (extension sets, connectors, securement devices, etc.) should be changed whenever a dressing change is performed. As always, follow your healthcare provider’s recommendations for the care and maintenance of your line. Below is a description of the components in a standard dressing kit, and how they are used

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Changing Dressing on Central Line

Pediatric – Changing Central Line – Intermountain Healthcare

Helpful Information

A central line dressing change involves replacing the sterile dressing over the central venous catheter (CVC) insertion site. It’s crucial to maintain a sterile environment and change the dressing at least every 7 days for clear dressings, or every 2 days for gauze dressings, to prevent infection.

Here’s a step-by-step guide:

1. Prepare the area and yourself:

- Wash hands: Wash your hands thoroughly with soap and water for at least 15-30 seconds, or use an alcohol-based hand sanitizer.
- Gather supplies: Ensure you have a clean work surface, sterile gloves, a new dressing (gauze or clear), cleaning solution (e.g., chlorhexidine), and any other necessary supplies (like skin protector).

Put on a mask: Wear a surgical mask to minimize contamination of the sterile field.

2. Remove the old dressing:

Gently peel off:

Remove the old dressing, starting at the bottom and peeling upwards towards the top, avoiding direct contact with the catheter insertion site.

Inspect the site:

Carefully inspect the insertion site for any signs of infection, such as redness, swelling, drainage, or tenderness.

3. Clean the insertion site:

Use cleaning solution: Clean the insertion site with a cleaning solution provided by your doctor or using alcohol swabs.

Clean in a circular motion: Clean the area in a circular motion, working outwards from the insertion site.

Let it air dry: Allow the area to air dry completely for about 30 seconds.

4. Apply the new dressing:

Apply skin protector: If using a skin protector, apply it around the edges of the cleaned area.

Apply the new dressing: Apply the new dressing, whether it’s a gauze or a clear dressing, over the insertion site.

Secure the catheter: Tape the catheter to the skin to prevent it from moving or being pulled.

5. Final steps:

Wash your hands: Wash your hands again after applying the new dressing.

Document the change: Note the date and time of the dressing change, along with any observations about the site.

Important Considerations:

Sterile technique: Always maintain a sterile environment throughout the dressing change process.

Inspect for infection: Regularly inspect the insertion site for signs of infection.

Follow instructions: Adhere to the specific instructions provided by your doctor or nurse.

Seek medical advice: If you notice any concerning signs or have questions, contact your healthcare provider or nurse.

Central Line Dressing Change
A central line (PICC, port, Hickman or other tunneled catheter) dressing change is a sterile procedure. Because of this, we strongly recommend that you receive training by a healthcare professional familiar with central line care and maintenance. There are many subtle ways a sterile surface can become contaminated, which puts you at risk for blood stream infections. These infections can be very serious, and even life threatening. The central line dressings should be changed a minimum of every seven days – every 48hr if gauze is used. If at any time the dressing peels, becomes wet underneath, becomes dirty, etc. it should be changed immediately. All components that can be changed (extension sets, connectors, securement devices, etc.) should be changed whenever a dressing change is performed. As always, follow your healthcare provider’s recommendations for the care and maintenance of your line. Below is a description of the components in a standard dressing kit, and how they are used.

Central line dressing change
A central line (PICC, port, Hickman or other tunneled catheter) dressing change is a sterile procedure. … The central line dressings should be changed a minimum of every seven days – every 48hr if gauze is used.

All components that can be changed (extension sets, connectors, securement devices, etc.) should be changed whenever a dressing change is performed. As always, follow your healthcare provider’s recommendations for the care and maintenance of your line. Below is a description of the components in a standard dressing kit, and how they are used.

Flushing Your IV Access

There are many different protocols for flushing your IV access and this depends on several factors. What type of line do you have (PICC line, port, peripheral line?) How are you using your line – continuously or intermittently? Is it one lumen or two? What type of catheter is it? What solutions does your doctor want you to use – saline alone or saline and heparin? Following are general guidelines for flushing – for more specific information, please consult your healthcare provider.

Nursing provides prefilled saline and heparin flushes for your convenience. They are ready to use; the solution is already in the syringe.

Wash your hands.

1 Gather your supplies.This should include alcohol wipes and your flushes.

2 Vigorously wipe the end of your connector attached to your line with an alcohol prep.

3 Take the syringe out of the outer plastic bag and remove the cap. Very Important: The end of the syringe must not touch anything else once the cap is removed! (The end of the syringe must remain sterile.

The syringe may have a little air bubble in it. By holding the syringe upright with the plunger at the bottom you can gently push up on the plunger and until the air bubble is gone and you see a drop of the solution come out the tip.

4 Attach the syringe to your connector at the end of your line. Do this by holding the connector in one hand, and twisting the syringe on, so it does not come off. You will need to exert some pressure to twist it on. The syringe should stay attached to your line when you let go.

5 Exert pressure on the plunger of the syringe to flush your line. The fluid should empty into your line with only slight pressure. Should you feel significant resistance and are not able to flush, contact your Healthcare Provider.

These syringes are one-time use only. You should not re-use a syringe as this will not maintain sterility.

If you are infusing a medication, you will connect the end of your tubing in the same way you attached the flush syringe – it will twist on. Be sure to wipe your connector vigorously with an alcohol prep before connecting!

You will always precede and follow medication with a saline flush. Heparin is used in some cases to maintain the patency of your line (keep your line open.) This would be used after the second saline. There is an acronym to help you remember: SASH

Saline, Additive (the medication), Saline, Heparin