UAB PHARMACY SERVICES
Step-By-Step Instructions
TROUBLESHOOTING WITH INFUSION THERAPY: CENTRAL VENOUS CATHETER-ASSOCIATED COMPLICATIONS There are different types of venous access, such as a PICC( peripherally inserted central catheter), the Hickman( tunneled central catheter), ports, midlines, and peripheral lines. Your home care nurse will check your IV line and teach you how to care for it.
Depending on the type of line you have, it may also be used to collect blood samples for lab studies. As with any type of treatment, there are certain problems that can happen.
PROBLEM POSSIBLE CAUSE WHAT TO DO
Accidental removal of the catheter from the chest
The catheter is no longer in place. THIS REQUIRES AN EMERGENCY RESPONSE.
Apply firm pressure to the exit site and chest area above it with a gauze dressing or clean washcloth. Call 911.
Shortness of breath, coughing, fast heart rate
Swelling or pain in your neck, shoulder, face, or arm on the side of the catheter
Accidental catheter movement or complete removal from the arm
Pain, redness, warmth, swelling, or pus-like drainage where catheter enters your skin
Unexplained fever and / or chills
Leaking of fluid from catheter or at IV site
Blood in catheter or tubing
Difficulty flushing the catheter
Skin rash or itching. There may be swelling of face, hands, or eyelids, and wheezing or shortness of breath may occur. You may also have a fever.
These are signs of a possible blood clot or pulmonary embolus. THIS REQUIRES AN EMERGENCY RESPONSE.
THIS REQUIRES AN EMERGENCY RESPONSE.
The catheter may be displaced if it appears longer or if a“ cut” is visible at the exit site or if the catheter is no longer working.
These are signs of an infection.
This is a sign of a possible infection or a drug reaction.
There may be a loose connection, or there may be damage to the catheter, such as a hole or crack.
Some amount may be normal. There may be a loose connection, or the IV bag may not be high enough.
The catheter may be clamped, or your catheter could have a blood clot; this can be fixed.
These are signs and symptoms of an allergic reaction.
Make sure the catheter is clamped. Lie down on your left side with your head flat and your feet up. Stay in this position while your caregiver calls 911.
Stop using your catheter and make sure the catheter is clamped. Call 911 and your nurse or doctor right away.
Do not use the catheter. Tape the catheter to your skin if it seems loose. If your IV site is bleeding, or if the catheter is completely out of the arm, apply clean gauze and pressure to the site. Call your nurse or doctor right away.
Stop infusion or do not start infusion. Call your nurse or doctor right away.
Stop infusion or do not start infusion. Call your nurse or doctor right away.
Check and tighten the connection. If leaking continues, stop your infusion and do NOT flush the line. Clamp the catheter as close as possible to the insertion site. If necessary, pinch or fold it to clamp it. Some catheters can be repaired. Cover the hole or crack with sterile gauze. Call your nurse or doctor right away. Never use scissors or sharp objects near the catheter.
Check and tighten the connections. Raise the bag. Flush the line with a saline flush if your medication does not infuse or if the blood does not clear from the line. Call your nurse or doctor right away if you are not able to flush the catheter.
Make sure the catheter is not clamped. Change your position by raising your arms, lying down, coughing, or taking a deep breath. If the catheter still will not flush, stop using it and call your nurse. Never use force to flush the catheter.
Stop infusion, clamp the catheter, and do not restart infusion. If you have a severe reaction or if your symptoms worsen, call 911. Otherwise, call your nurse or doctor immediately.
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