penelope3000

Thank you for your input. Yes we are doing as you say regarding confirmed infections. (pulling out the existing line, waiting 48hrs and reinserting new line) The cases that we recently had were for blocked, malfunctioning lines, or exposed cuff. We have been doing much the same as you describe. We use a non scrub nurse and another tech to clean the old tube with a dressing tray while the scrub nurse prepares the procedure tray. Cleaning the tube really well with chlorhexidine. The assistant holds the tube up (with sterile gloves on) as this part can be very awkward. We take off the old caps, clean the ends and put clean ones on. Then we wrap a sterile gauze around the clamps, thin enough so the radiologist can feel them to manipulate them (secured with steristrips) and then he/she can hold on to the tube without actually touching it. The radiologist and scrub nurse change gloves after the old tube is removed. This is all vey time consuming but but not as much as an infected line. We do a lot of these and we are trying to be as consistent as possible. The radiologist is convinced that 2 recent line infections were due to us because it was within 48 hours of us putting them in. I will certainly read the pdf. Thanks!

In my IR (Radiology) dept. we are having a crisis over the fact that we really don't know what is the best way to deal with the old line when doing dialysis line exchanges. We all have great ideas but it is becoming very inconsistant and cumbersome.Currently- A circulating tech/nurse will remove the dressing, don sterile gloves and clean the catheter with a dressing tray while the scub nurse/tech prepares the tray. The first tech/nurse will then hold the catheter up while the second person cleans the skin. A sterile gauze is wrapped around the ends so the radiologist does not actually touch the catheter during the procedure. Does anyone out there have any comments/ideas for us? We recently had some lines come back infected and attributed to us so we want to do whatever will help.