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Central venous catheter - dressing change

  • Description
    • You have a central venous catheter. This is a tube that goes into a vein in your chest and ends at your heart. It helps carry nutrients and medicine into your body. It is also used to take blood when you need to have blood tests.

      Dressings are special bandages that block germs and keep your catheter site dry and clean. This article describes how to change your dressing.

  • Alternative Names
    • Central venous access device - dressing change; CVAD - dressing change

  • What to Expect at Home
    • Central venous catheters are used when people need medical treatment over a long period.

      • You may need antibiotics or other medicines for weeks to months.
      • You may need extra nutrition because your bowels are not working correctly.
      • You may be receiving kidney dialysis.
      • You may be receiving cancer drugs.

      You'll need to change your dressing often, so that germs don't get into your catheter and make you sick. Follow your health care provider's instructions on changing your dressing. Use this sheet to help remind you of the steps.

      You should change the dressing about once a week. You will need to change it sooner if it becomes loose or gets wet or dirty. After some practice, it will get easier. A friend, family member, caregiver, or your doctor may be able to help you.

      Your doctor will tell you when you can shower or bathe after surgery. When you do, make sure the dressings are secure and your catheter site is staying dry. DO NOT let the catheter site go under water if you are soaking in the bathtub.

  • Supplies You Will Need
    • Your doctor will give you a prescription for the supplies you will need. You can buy these at a medical supply store. It will be helpful to know the name of your catheter and what company made it. Write this information down and keep it handy.

      When your catheter is put in place, the nurse will give you a label that tells you the make of the catheter. Keep this for when you buy your supplies.

      To change your dressings, you will need:

      • Sterile gloves
      • Cleaning solution
      • A special sponge
      • A special patch, called a Biopatch
      • A clear barrier bandage, such as Tegaderm or Covaderm
  • Changing Your Dressings
    • You will change your dressings in a sterile (very clean) way. Follow these steps:

      1. Wash your hands for 30 seconds with soap and water. Be sure to wash between your fingers and under your nails. Remove all jewelry from your fingers before washing.
      2. Dry with a clean paper towel.
      3. Set up your supplies on a clean surface on a new paper towel.
      4. Put on a pair of clean gloves.
      5. Gently peel off the old dressing and Biopatch. Throw away the old dressing and gloves.
      6. Put on a new pair of sterile gloves.
      7. Check your skin for redness, swelling, or any bleeding or other drainage around the catheter.
      8. Clean the skin with the sponge and cleaning solution. Air dry after cleaning.
      9. Place a new Biopatch over the area where the catheter enters your skin. Keep the grid side up and the split ends touching.
      10. Peel the backing from the clear plastic bandage (Tegaderm or Covaderm) and place it over the catheter.
      11. Write down the date you changed your dressing.
      12. Remove the gloves and wash your hands.
  • Other Care
    • Keep all the clamps on your catheter closed at all times. It is a good idea to change the caps at the end of your catheter (called the "claves") when you change your dressing. Your provider will tell you how to do this.

  • When to Call the Doctor
    • Call your provider if you:

      • Are having trouble changing your dressings
      • Have bleeding, redness or swelling at the site
      • Notice leaking, or the catheter is cut or cracked
      • Have pain near the site or in your neck, face, chest, or arm
      • Have signs of infection (fever, chills)
      • Are short of breath
      • Feel dizzy

      Also call the doctor if your catheter:

      • Is coming out of your vein
      • Seems blocked, or you are not able to flush it
  • References
    • Smith SF, Duell DJ, Martin BC, Aebersold ML, Gonzalez L. Central vascular access devices. In: Smith SF, Duell DJ, Martin BC, Aebersold ML, Gonzalez L, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2017:chap 29.