Monitoring of the catheter site

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Summary:

Collaborate and form a team with your child. When you invest the time to form a strong team, children feel more comfortable and less anxious – this will help you complete the care with less stress – for you and your child.

Use these tips, from the start, to set the stage for a positive care procedure:

• Create the right moment: integrate the care in a routine.
• Alert your child to the needed care and communicate together.
• Form a team with your child: Encourage autonomy by offering realistic choices such as the method of distraction. Stay tuned to your child. Manage pain and anxiety, using distraction and positioning for comfort.

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Summary:

• Prepare the environment: Identify a routine place for care. Close windows, doors and fans. Wash and dry the work surface and gather the needed materials for the care and to distract your child.
• Prepare your child: Get help if needed. Position your child for comfort to receive the care and start to use the selected distraction method.
• Prepare yourself: Find the right time when you are ready to provide the care safely. Review the list of care steps. Wash your hands.

Now that you are ready to start the care procedure, take the opportunity to encourage and praise your child.

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Summary 3 key concepts:

• Safety: Carefully follow the care practice steps as you have been taught.
• Flexibility: Be ready to adjust according to your child’s reactions during the procedure. As needed, reposition or select an alternative distraction strategy. Follow your child’s pace and rhythm.
• Collaboration: Reassure your child, verbally and non-verbally. Acknowledge your child’s emotions and reactions. Help your child differentiate between the different sensations during a procedure.

Position your child:

• to easily reach the catheter entry site,
• in one of the positions discussed with your healthcare team,
• consider your child’s age and ability to collaborate.

This step allows you to more easily view the catheter entry site and keeps your child comfortable.

• The catheter entry site should not change in appearance.
• Do not give the antibiotic or press the “STOP / START” button on the pump (or close the pump as indicated) if:
  • you observe that the site is red, hot, swollen or sensitive to touch,
    
  • there is redness, sensitivity under the dressing or a cord-like feeling along the length of the vein where the catheter is inserted,
  • you notice that the skin is cold around the catheter, that the arm is swollen or if your child reports burning or pain at the entrance site of the catheter.
• Close the clamps of the catheter tubing and the tubing of the pump.
• Contact your healthcare team quickly.

This step allows you to quickly detect problems.

• The dressing should be kept clean and dry at all times.
• If the dressing is wet or blood stained, do not remove the old dressing. The catheter site should always be protected.
• If the dressing is falling off, tape the sides down.
• If the dressing is punctured or torn, install another clear adhesive dressing over the old one.
• Immediately contact your care team.
  

This step helps you quickly identify complications.

• Tubing should not be pinched or bent.
• Make sure the extension tubing is securely fastened. If necessary, use adhesive tape to keep the tubing in place.

This step helps to avoid complications.

• The outer part of the catheter must remain the same length at all times; it should not move, neither inwards or outwards.
• If you notice a change in length of the external portion of the catheter, DO NOT push the catheter back into the vein; contact your healthcare team immediately.

This step will confirm the catheter has remained in the proper position. Allows quick action if the catheter has moved out of the proper position.

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Summary:

The treatment is finished. Wash your hands again.

Be prepared to recognize the challenges faced and to provide positive feedback. Help your child recognize his/her strengths. Acknowledge the collaborative teamwork.

• Listen to what your child says about the parts of the procedure that were difficult or painful.
• Comfort your child and recognize your child’s collaboration with positive feedback.
• Highlight your child’s  specific strengths that helped make the procedure positive.
• Discuss with your child what might be done the same or differently the next time the care is needed.
• Keep your promises if you have promised a reward, follow through.
• Reward yourself too.