Page updated 30 April 2007
Tunelled Intravenous Lines and Intrathecal Cannulae (e.g. Epidural Lines/Neurological Shunts)
The risk of infection with these devices is so high and the consequences so grave that aseptic insertion and handling are essential. Insertion will normally be done in the operating theatre.
Routine Change of Equipment for Intravascular Lines
| Equipment used in clinical practice | Rationale | Routine interval | Ref. |
|---|---|---|---|
| Dry gauze and adhesive tape | Place on insertion site to absorb exudate and blood | 24h | 1 |
| Transparent semi-permeable polyurethane dressing, e.g.:1. Opsite IV 3000 2. Tegaderm. | Inspect without disturbing dressing. An effective barrier to micro-organisms. Permeable to water vapour, prevents build up of condensation. Self adhesive nature of dressing | Leave undisturbed for 5-7 days, unless soiled with blood or exudate, or becomes loose. Redress soiled and wet dressing immediately | 1,23 |
| 3-way taps and connectors | Delivery port used for IV injections. | Change every 3-4 days | 4,5 |
| Luer-lock connectors | Reduce accidental disconnection, subsequent contamination or air embolism | Change every 3-4 days | 4,5 |
| Administration set for | |||
| Clear fluids | Reduce colonisation | 72 hours | 6 |
| TPN | Dedicated line | 24 hours | 7 |
| Blood products | Separate line | After completing transfusion | 7 |
| Arterial pressure transducers | Reduce risk of bacterial contamination. Use aseptic technique when handling item | 2-5 days | |
References
3. Cornock M. Making sense of central venous catheters. Nurs Times. 1996 Dec 4-10;92(49):30-1. Review.
4. Sansivero GE. Why pick a PICC? What you need to know. Nursing. 1995 Jul;25(7):34-41; quiz 42.
5. Henderson N. Central venous lines. Nurs Stand. 1997 Jul 9;11(42):49-54; quiz 55-6.
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