Getting Ready for Your Transplant: Central Line Care

A central line is an intravenous line that is placed in a large vein. Placement of these catheters is often needed for prolonged medication or nutrition administration.

Notes

  • If your child’s dressing is un-occlusive or no longer sticking to their skin, it is best to sterilely change the dressing to avoid bacteria entering the insertion site and acquiring a central line associated blood infection.
  • To change central line dressing, gather supplies: Dressing change kit and a transparent dressing. Prepare supplies on sterile field by removing from packaging. Some kits may appear different from what we are using. Include 2 chloraprep swabs, chlorohexidine bio-patch, mastisol or any sticky adhesive, and skin prep to protect your child’s skin.

Procedure:

  1. Preform hand hygiene
  2. Clean area with an antibacterial/antimicrobial wipe to disinfect the surface
  3. Place mask on patient, self, second person, and anyone within 3 feet of the patient during dressing change.
  4. Open removal pack of dressing kit.
  5. Preform hand hygiene with hand sanitizer.
  6. Apply sterile gloves for dressing removal.
  7. Place first sterile glove on dominant hand, touching only the outer cuff (non-sterile portion) with your non dominant hand.
  8. Place second sterile glove on non-dominant hand, ensuring to only touch the sterile portion of the glove with your dominant sterile hand.  
  9. Remove dressing from skin using an adhesive remover starting at the catheter lumens, or bottom of dressing, then pulling away from the insertion site in an upward motion Remove old chlorhexidine patch if present.
    Note: Only specially trained employees can change a statlock or stabilization device. DO NOT change the stabilization if there is one present and you are untrained.
  10. Open application pack in dressing kit
  11. Open and drop new sterile dressing onto sterile field. Make sure not to touch any part of the dressing until you are sterile.
  12. Preform hand hygiene.
  13. Put on sterile gloves. Place first sterile glove on dominant hand, touching only the outer cuff (non-sterile portion) with your non dominant hand. Place second sterile glove on non-dominant hand, ensuring to only touch the sterile portion of the glove with your dominant sterile hand.
  14. Prepare supplies on sterile field by removing from packaging. Some kits may appear different from what we are using. Include 2 chloraprep swabs, chlorohexidine bio-patch, mastisol or any sticky adhesive, and skin prep to protect your child’s skin.
  15. Disinfect insertion site, any part of catheter that will be under the dressing, and any area that extend beyond the dressing in a basket weave motion (back and forth/up and down).
  16. Scrub for 30 seconds using friction to disinfect area.
  17. Allow to air dry for a minimum of 30 seconds without fanning or blotting. This ensures if any bacteria present, the skin will be properly disinfected.
  18. Apply biopatch (chlorhexidine patch) to catheter insertion site. Remember, blue to the sky. Use in caution in patients less than 2 months of age.
  19. Apply sticky or adhesive in a border outside the insertion site where the dressing will be.
  20. Position dressing over insertion site using sterile technique as demonstrated. Do not touch adhesive or sticky portion of dressing to gloves.
  21. Position small dressing piece under lumens overlapping large dressing, creating occlusive seal around the catheter without adhesive or sticky portion of dressing touching gloves.  
  22. Record date and initials directly on dressing. A child’s central line dressing should be changed every 7 days, or sooner if no longer adhering to the skin.

Note: If your child had a statlock or securement device present and you did not remove it, the date on the dressing should remain within 7 days of when the statlock was last changed. A trained professional will change the dressing with the statlock.

This information should not replace medical advice from your doctors or medical team. We encourage our readers to follow their transplant team's medical advice and reach out to their doctors and medical team for further recommendations.