Dialysis Subclavian line antibiotics.

Nurses Safety

Published

Specializes in Emergency Room.

So I am wondering, is it wrong to run an ABX through a dialysis subclavian line? I mean it's still a central line? I was told in the ED you can't run abx through a dialysis subclavian line. Any reasoning behind it????

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Specializes in Vascular Access.
So I am wondering, is it wrong to run an ABX through a dialysis subclavian line? I mean it's still a central line? I was told in the ED you can't run abx through a dialysis subclavian line. Any reasoning behind it????

First and foremost, you must follow the instituional policies at your place of employment.. but with that being said, this "dialysis" catheter is the patient's lifeline. Normally, staff nurses from all floors stay away from the line, and only assess to ensure that the line has a C/D/I dressing covering it. The only ones who "normally" manipulate the line are actual dialysis nurses. Some institutions may have policies in place which delineate what to do in an emergency setting and the patient is coding and the only thing they have for access is this Dialysis Catheter. But, I can't imagine that this was a matter of life or death for an IVAB.

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The dialysis nurses will run ABs though the line after HD, at times. General floor (or ER) nurses at all of the facilities I have worked at were not allowed to touch HD accesses, in general.

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Specializes in Emergency Room.

But then blood can be drawn from it....

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As mentioned, you need to refer to your facility's policies. Where I work, aside from emergency access during an acute resuscitation, non-dialysis use requires approval from the Nephrology attending.

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Specializes in ICU.

Some HD catheters have what I call a 'pig tail' which is a central line built into the catheter. The red and blue HD ports shouldn't be used by anyone except the dialysis nurse (Unless it's an emergency). I've gotten a patient from the ER with antibiotics hooked up to their HD central line and had to call the md to get an order to heparinize the port after I unhooked it. The amazing part about it is that there was an actual pig tail port on this catheter, the ER nurse had no idea what she was doing. Needless to say, staff was educated throughout the hospital after this incident.

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Specializes in Emergency Room.

doesn't the color differentiate arterial/venous? But in reality does it harm the patient?

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.
non-dialysis use requires a Prova from the Nephrology attending.

What is a Prova?

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What is a Prova?

Post corrected, should have read approval.

Darn auto correct.

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.
Post corrected, should have read approval.

Darn auto correct.

Ok thanks, didn't know if it was a brand name of a type of dialysis catheter!

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Specializes in ICU.
doesn't the color differentiate arterial/venous? But in reality does it harm the patient?

From what I understand, there's a big risk for clotting of the line when it's not properly managed.

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Specializes in Critical Care.
doesn't the color differentiate arterial/venous? But in reality does it harm the patient?

No, they're both venous.... That just differentiates which one goes to the machine and which one goes to the pt.

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