Patient with a vas cath..........care question

[AtlantaRN, RN]

Admitted a patient with a right subclavian vas cath. She is getting dialysis 3x/week. I know we don't flush or anything like that, but do you all write, like you would any other invasive item....such as a peg tube.....to change the dressing if soiled, visualize and document site appearance each shift?

Also patient has a wound vac that is cared for by a home health agency (one of those dual billing things....), I need to write that patient has a wound vac, but indicating that home health writing orders and caring for item...

I'm just tired, I can't think well when I'm tired......2 admits last weekend and I have to turn in paperwork in am.

Thanks for your help!

linda

[NotReady4PrimeTime, RN]

Does your facility have a central line policy? You should check that out and see what it says about dressing changes. I would expect that the dialysis unit would be changing it as needed. The site should be visible if the dressing is a tranparent membrane type like Tegaderm or IV3000 and should be assessed q shift... It should definitely be labeled DO NOT FLUSH because there's enough heparin in each lumen to seriously harm your patient.

[AtlantaRN, RN]

oh yeah, we would never flush a vas cath. it's one of those things, when i'm tired, i can't think straight............its just we have to visualize and document "no s/s infection...no redness, etc" if there were blood visible under the dressing or it looked "angry" we could change the tegadern and use alcohol/iodine swab to clean and apply a new tegaderm...

i've gotten some sleep....back to baseline. thanks again

linda