CARE OF
TEMPORARY
CATHETER
MUGILAN
MAA MEDICARE BUTTERWORTH
Care of Temporary Catheter by mugilan
Answered this question 1st.
How many types of catheter?
Where are the placement of catheter?
What indication for insertion of catheter?
What the most important things should be done before
and after insertion of catheter?
What we should do if exit site of catheter had a infection?
Care of Temporary Catheter by mugilan
Indication Temporary Vascular
access Catheter
Patient waiting for create AV fistula and fistula to matured
Patient with fistula problem
CAPD patients, which need temporary
Patient with Acute Renal Failure which on HD treatment while
wait for renal re function
Patients on Plasmapharesis or Immunosorption
Care of Temporary Catheter by mugilan
These are the special things that need to be done:
preventing infection.
changing the dressing.
flushing the catheter.
giving the medicine.
changing the injection cap.
solving problems.
knowing when and who to call for help.
Care of Temporary Catheter by mugilan
TYPE OF CATHETER
Care of Temporary Catheter by mugilan
Care of Temporary Catheter by mugilan
WHAT IS DIALYSIS CATHETER?
Access at patients body for BLOOD to and from the
hemodialysis machine
Had TWO lumen.
- The arterial lumen (typically red) withdraws blood from
the patient and carries it to dialysis machine.
- venous lumen (typically blue) returns blood to the
patient (from the dialysis machine)
Care of Temporary Catheter by mugilan
Cont.. (placement)
The catheter is placed in one of the large veins.
A common site is superior vena cava or SVC.
An SVC catheter is placed by puncturing the
internal jugular vein in the neck (most often
on the right side), and the catheter is then
advanced downwards toward the chest.
Care of Temporary Catheter by mugilan
via subclavian vein right behind the
clavicle(the collar bone), often on the right.
FEMORAL VEIN = This is an inferior option, because the GROIN site
is more prone to INFECTION and also because patient cannot sit
upright.
Care of Temporary Catheter by mugilan
FEMORAL CATHETER
SIZE :
-12.5FR X 24CM
-12.5FR X 20CM
-12.5FR x 25cm
For short term dialysis
-should replaced every 2weeks.
Care of Temporary Catheter by mugilan
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IJC
SHOULD BE REPLACED AFTER 4-6WEEKS
SIZE:
-11.5FR X 16CM
-12FR X 16CM
Care of Temporary Catheter by mugilan
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PERMANENT CATHETER
Patient with difficulty to create AV fistula
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COMPLICATION
clotting
infection
kinking
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CARE OF PATIENT BEFORE
INSERTION OF CATHETER
CONSENT
BLOOD IX FBC, PT/APTT
VITAL SIGN
CATHETER
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DURING INSERTION
MONITOR VITAL SIGN
- OBSERVED FOR BLEEDING
- MAINTAIN STERILITY
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CARE OF PATIENT AFTER
INSERTION CATHETER
B/P
SIGN AND SIMPTOM OF
-INFECTION = fever, chills and rigor
-HAEMATOMA = patient c/o S.O.B (IJC)
-BLEEDING
Should be CHEST X-RAY 1st BEFORE proceed treatment and
REVIEW by doctor .
Informed Doctor immediately if patient had complication.
Care of Temporary Catheter by mugilan
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TROLI DRESSING
-GAUZE
-POVIDONE
-KEYHOLE
-BACTROBAN CREAM
-DISPOSIBBLE DRESSING SET
Care of Temporary Catheter by mugilan
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DRESSING OF CATHETER..
Wear gown
Wear face mask
Wash hand 1st
Wear sterile glove
Care of Temporary Catheter by mugilan
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OPEN DRESSING PACKED
- monitor sign and simptom of infection. (temperature, redness, pain,
pus @ exit site)
- if had infection take blood c&s and swab c&s
DO NOT proceed treatment if infection occurred. Please
informed doctor 1st.
of Temporary Catheter by mugilan
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- Care
Given
antibiotic as prescribed by doctor after dialysis.
Cont
Clean with iodine povidone (soaked @ cotton) 1st 3x or depending
on exit site of catheter (circulation method).
Clean lumen with gauze (from exit site to end of lumen). Each
lumen used one gauze.
Care of Temporary Catheter by mugilan
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Cont
2nd time clean with spirit ( same with before)
Care of Temporary Catheter by mugilan
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Cont
Packed with keyhole (flavine / bactroban cream)
Put sterile gauze on top of keyhole.
Plastered
Care of Temporary Catheter by mugilan
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Cont
Covered both lumen of catheter with sterile plastic.
Care of Temporary Catheter by mugilan
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Cont..
Syringe out 2cc from each lumen (withdraw heparine pure)
Flushing in/out each lumen. Used normal saline with 10cc syinge.
To tested if catheter functioning well or not.
Care of Temporary Catheter by mugilan
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Cont
Connected line
- Swab with spirit 1st before connected.
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CONT
Wrapped both lumen with gauze (soaked with povidone)- to
prevent colonized of bacterial.
DO NOT used micropore !!!!
Wrapped with plastic
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End of treatment
Flushed
with normal saline
Blocked
with heparin pure 5000unit
depends on length of lumen each catheter.
Stopper
Wrapped
properly both lumen with sterile
gauze and plastered tightly.
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Health education to patient
Informed
medical staff if got fever, pain and itchiness @ exit
site
Do
not go private clinic if not feeling well
Do
not open dressing packed @ home
Do
not scratched on dressing site.
Do
not cut catheter.
If
catheter pulled out @ home- compressed with clean cloth.
Care
Immediately
of Temporary Catheter
go
straigth to A&E
by mugilan
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