Intravenous antibiotic therapy

What is it?

An infection occurs when a microbe (eg, bacteria, virus, etc) invades a part of the body and prevents it from functioning properly. The human body has several natural defenses to fight infections. For various reasons, it sometimes happens that the body fails to defend itself.
When bacteria are the cause of an infection, it is possible to block their growth and destroy them with drugs called antibiotics. To be effective, an antibiotic must come in contact with the bacteria for a specific length of time. This contact can be made in different ways: through the skin, through the mouth, through the blood (intravenous=IV).
Your doctor has determined that intravenous antibiotic treatment at home is most appropriate for your child. With proper monitoring and proper daily care, this antibiotic therapy is effective, comfortable and safe.

How does it work?

To receive an antibiotic intravenously, the equipment required includes:
- a catheter (thin flexible tube) is installed through the skin and inside a vein to allow the drug to enter the bloodstream;
- the catheter is attached to tubing (small flexible plastic tube on the outside of the skin) which has a clamp and a needleless connector (or injection cap); this connector is usually attached to longer tubing called the extension tube;
- a transparent dressing protects the insertion site of the catheter, where the catheter enters the skin;

- an elastomeric infusion pump, bag or cassette reservoir contains the antibiotic;
- the bag or cassette reservoir is connected to an ambulatory infusion pump (eg, CADD-Legacy® PLUS, CADD-Prizm® VIP or CADD®-Solis VIP) via tubing;
- the flow rate of the antibiotic is programmed and controlled by the pump.
The choice of the type of catheter depends on the duration of the treatment, the age of the child, the health condition and the condition of the veins.
Several kinds of catheters exist:
- Short peripheral catheter: short thin tube about 1 to 4 cm inserted into a small vein (eg, in the hand or the forearm). This type of catheter is useful for short term IV therapies.

- Peripherally inserted cental catheter (commonly referred to as “PICC line”): long thin tube inserted in a larger vein of an arm and which follows its path to the entrance of the heart. This type of catheter is useful when IV therapy is required for more than a week.

- Central tunnel catheter (eg, Broviac®): this type of catheter is inserted partly under the skin of the chest and is threaded through a larger vein towards the heart. This type of catheter is useful when longer term IV therapies are needed.

- Implantable chamber catheter (eg, Port-a-Cath®): includes a small reservoir inserted under the skin and attached to a catheter which is inside a large vein leading to the heart. The reservoir is accessed by piercing the skin with a special noncoring needle (eg, Huber needle). This type of catheter is useful when long term IV access is required.

Several types of infusion systems can be used to administer intravenous antibiotics:
- Elastomeric infusion pump or portable infusion pump (eg, Intermate infusion pump): a plastic case contains an elastic balloon-shaped reservoir that inflates when filled with the prescribed amount of antibiotic.
  This balloon exerts a gradual pressure on the medication which can thus flow into the tubing then into the catheter and the vein.
  A flow controller limits the speed of medication release from the pump.
  Each elastomeric infusion pump contains a single dose of medication.

Ambulatory infusion pump: the antibiotic is contained in a reservoir, in sufficient quantity for the day.
If this reservoir is a bag, then the bag tubing is connected to a tubing with cassette which is connected to the pump. The tubing of the cassette is connected to that of the catheter, with or without extension tube.
If this reservoir is a cassette reservoir, it is directly connected to the pump and the cassette reservoir tubing connects to the catheter tubing, with or without an extension tube.
Some models of ambulatory infusion pumps have an air detector for their tubing and a lock to secure the cassette or cassette reservoir to it.

The pump works with non-rechargeable batteries or a rechargeable battery (depending on model) and is light enough to be worn all day by most children (usually in a small backpack).
It is programmed to automatically deliver the antibiotic into your child’s catheter at the times prescribed by the doctor.
Outside these periods, a very small amount of medication is administered by the pump to prevent the vein from blocking. Your child stays connected to the pump.
A CADD brand pump is commonly used in children, especially the Legacy®PLUS, Prizm ®VIP or ®Solis VIP models. The CADD-Legacy® PLUS pump was chosen to illustrate the steps of the care shown here.

Your child’s healthcare team will supervise the IV treatment and ensure that the equipment is functioning properly. Ask your healthcare team about specific recommendations for your child, including the procedure for changing the protective dressing which protects the insertion site of the catheter.

Refer to your healthcare team if the equipment used for your child is different from what is described in the methods of care.

FAQ – Intravenous antibiotics

When to consult your healthcare team

General state of health

When your child has any of the following symptoms:

Fever (≥ 38⁰C rectal or ≥ 37.5⁰C buccal or ≥ 37.5⁰C armpit).
General irritability, poor appetite, fatigue or wanting to sleep more than usual (lethargy).
Signs and/or symptoms of dehydration:
- Decreased urination,
- Increased thirst,
- Dry lips and mouth,
- Faster heart rate than usual,
- Weight loss.

Intravenous catheter

The catheter entry site is red, swollen, hot or painful.
There is bleeding or other leakage at the entrance site of the catheter.
The color of the skin is pale or red around the entrance site of the catheter.
The skin around the entrance site of the catheter is cold or your child reports burning or pain at this location.
The length of the external portion of the catheter has changed (length is shorter or longer than usual) or the catheter is completely removed from the vein.
There is redness or itching of the skin under the dressing.
The dressing is damp or soiled with pus or other discharge.
The dressing is peeled off, punctured or torn.
There is redness, sensitivity or a cord-like feeling along the vein where the catheter is inserted.
Irrigation/flushing of the catheter is difficult or impossible.
The catheter is broken.
If your child has an implantable chamber catheter (eg, Port-a-Cath®): pain or swelling at the site of insertion of the reservoir during the administration of the solution or irrigation.
Your child:
- complains of pain in the ear, throat, neck, armpit or shoulder on the same side of the catheter;
- smells a particular odor or has a strange taste in their mouth during irrigation of the catheter;
- hears an unusual sound during irrigation of the catheter or administration of medication;
- has swelling in the neck, face or the arm on the same side as the catheter.

Equipment for administering the medication

The medication bag, cassette reservoir or balloon reservoir contains air bubbles or particles.
Medication takes longer than usual to administer, and you cannot solve the issue.
There is more solution left than expected in the medication bag/cassette reservoir at the end of administration.
There is more solution left than expected in the balloon reservoir at the end of administration (the balloon should be empty, flattened and small ridges visible).
The needleless connector or extension tubing is broken or inadvertently disconnected.
A piece of equipment is broken.
You are unable to operate the ambulatory infusion pump correctly or to correct problems related to the alarms.
The ambulatory infusion pump screen is broken or displayed incorrectly.

Your child’s healthcare team will take the opportunity during your child’s follow-up appointments to review your child’s care and equipment. Adjustments will be made as required.

Do not hesitate to refer to your child’s healthcare team for any questions or for specific advice related to your child’s condition.

WARNING: The information in this section is meant as a general guide to help parents and caregivers with common issues and is not intended to replace the care provided by your child’s healthcare team.

Discuss your child’s unique needs with your healthcare team, including WHO and WHEN to contact when problems arise.

Fever with or without other symptoms: ≥ 38⁰C rectal or ≥ 37.5⁰C buccal or ≥ 37.5⁰C armpit

Possible cause(s)

Ongoing infection for which your child is being treated
Infection of the skin at the catheter entry site
Blood infection
Other infection

What to do?

Note any other symptoms that your child may have including: pain, irritability, loss of appetite, drowsiness, etc.
Contact your healthcare team quickly.

General irritability, poor appetite, fatigue or wanting to sleep more than usual (lethargy)

Possible cause(s)

Change in baseline health of the child may indicate new infection or other problem

What to do?

Note any other changes or symptoms that your child may have.
Contact your healthcare team quickly.

One or more of these symptoms: decreased urination - increased thirst - dry lips and mouth - faster heart rate than usual - weight loss

Possible cause(s)

Dehydration

What to do?

Contact your healthcare team quickly.
Give oral rehydration solutions to your child (eg, Pedialyte™, Gastrolyte™), if recommended by your healthcare team.

Redness, heat, swelling, tenderness or pain at the catheter entry site

Possible cause(s)

Infection or inflammation at the catheter entry site
Phlebitis (irritated vein)

What do to?

If your child uses an elastomeric infusion pump:
- stop the infusion by closing the catheter tubing clamp and the pump tubing clamp.
If your child uses an ambulatory infusion pump:
- press the “STOP/START” button on the pump to stop the infusion or shut the pump off as you have been shown by your healthcare team;
- close the clamps of the catheter tubing and the tubing of the pump.
Contact your healthcare team quickly.

Blood leaking at catheter insertion site

Possible cause(s)

Breakage or disconnection of the catheter or tubing
Recent catheter insertion
Child’s underlying health condition

What to do?

If there is continuous bleeding, put a compress over the dressing and apply firm pressure.
If your child uses an elastomeric infusion pump:
- close the catheter tubing clamp and the pump tubing clamp.
If your child uses an ambulatory infusion pump:
- press the “STOP/START” button on the pump or close the pump as indicated,
- close the clamp of the catheter tubing and the tubing of the pump.
Immediately contact your healthcare team.

One or more of these symptoms: burning or pain at the entrance site of the catheter, cold skin around the entrance site of the catheter, swelling of the arm (PICC line), swelling around the catheter catheter site, leakage at catheter entry site, change in skin color (whiteness or redness) around the catheter entry site

Possible cause(s)

Infiltration (medication is leaking out of the vein and into the skin)
Phlebitis of the vein (irritated vein)

What to do?

If your child uses an elastomeric infusion pump:
- close the catheter tubing clamp and the pump tubing clamp.
If your child uses an ambulatory infusion pump:
- press the “STOP/START” button on the pump or close the pump as indicated;
- close the clamp of the catheter tubing and the tubing of the pump.
Immediately contact your healthcare team.
If your child’s arm with the catheter is swollen, elevate it as much as possible.

Length of the external portion of the catheter has changed (length is shorter or longer than usual) or the catheter is completely removed from the vein

Possible cause(s)

Accidental displacement of the catheter
Mishandling of the catheter
Improperly adjusted dressing
Child has moved excessively and displaced the catheter

What to do?

Never push the catheter back into the vein.
If your child uses an elastomeric infusion pump: close the catheter tubing clamp and the pump tubing clamp.
If your child uses an ambulatory infusion pump:
- press the “STOP / START” button on the pump or close the pump as indicated;
- close the clamp of the catheter tubing and the tubing of the pump.
If the catheter has been completely pulled out, put a clear dressing over the previous entrance site.
Immediately contact your healthcare team.

Extended redness or itching of the skin under dressing

Possible cause(s)

Contact dermatitis (ie, skin irritation due to the dressing)
Sensitivity to the adhesive of the dressing
Sensitivity to disinfectant solution
Reaction of the skin to the disinfection technique

What to do?

Contact your healthcare team who may suggest:
- a change in dressing materials,
- use of a topical corticosteroid,
- a change in disinfection technique.

Protective dressing is wet or damp due to leakage of blood, pus or other discharge

Possible cause(s)

Breakage or disconnection of the catheter or tubing
Blockage of the catheter
Displacement of the catheter
Displacement of the needle if the child has an implantable chamber device
Infection
Contact dermatitis
Child’s underlying health condition

What to do?

If your child uses an elastomeric infusion pump:
- close the catheter tubing clamp and the pump tubing clamp.
If your child uses an ambulatory infusion pump:
- press the “STOP / START” button on the pump or close the pump as indicated;
- close the clamp of the catheter tubing and the tubing of the pump.
Immediately contact your care team.
If the dressing is falling off, put another dressing over it while waiting for the advice of your healthcare team.
If the dressing is partially detached, do not remove it as you might remove the catheter by mistake.

Dressing is falling off, loose, punctured or torn

Possible cause(s)

Various causes

What to do?

If the dressing is falling off, tape the sides down.
If it is punctured or torn, install another clear adhesive dressing over the old one.
If the dressing is partially detached, do not remove it as you can remove the catheter by mistake.
Immediately contact your healthcare team.

Cord-like sensation of the vein where the catheter is inserted (may be hard, red or tender to touch)

Possible cause(s)

Phlebitis (irritated vein)

What to do?

If your child uses an elastomeric infusion pump:
- close the catheter tubing clamp and the pump tubing clamp.
If your child uses an ambulatory infusion pump:
- press the “STOP/START” button on the pump or close the pump as indicated;
- close the clamp of the catheter tubing and the tubing of the pump.
Contact your healthcare team quickly.

One or more of these symptoms: swelling of the hand, arm or side where the catheter is located, underarm pain in the arm where the catheter is located, swelling of the neck and face

Possible cause(s)

Phlebitis of the vein (irritated vein)
Blood clot in the vein with the catheter

What to do?

Immediately contact your healthcare team.

Resistance or inability to irrigate (flush) the catheter

Possible cause(s)

Blockage or displacement of the catheter
Blockage of the tubing
Clamps are closed
Displacement of the needle in children with an implantable chamber device (PORT)

What to do?

Do not push the plunger of the syringe with saline solution or locking solution forcefully.
Make sure tubing clamps are fully open.
Check that the tubing is not pinched or bent.
Ask your child to:
- move the arm on the side of the catheter,
- turn on each side,
- cough,
- turn thir head towards the opposite side of the catheter or to bear down (as if they were going to have a bowel movement).
If your child has an implantable chamber catheter (eg, Port-a-Cath®): check if the needle has moved out of the correct position.
If the problem persists:
- close the clamp of the catheter tubing;
- stop attempting to flush the line;
- contact your healthcare team immediately.

Presence of blood in catheter tubing

Possible cause(s)

Return of blood (reflux)

What to do?

Irrigate the catheter with the saline solution. Refer to steps 5 and 8 to 12 of the “Catheter Irrigation” method of care.
If this happens more than once or twice a week, contact your healthcare team.

Broken (leaking) catheter or malfunctioning equipment

Possible cause(s)

Mishandling
Catheter or other defective equipment
Blocked catheter

What to do?

You may notice leakage of blood or fluid at the point where the catheter or other piece of equipment is broken.
If your child uses an elastomeric infusion pump:
- close the catheter tubing clamp and the pump tubing clamp.
If your child uses an ambulatory infusion pump:
- press the “STOP/START” button on the pump or close the pump as indicated;
- close the clamp of the catheter tubing and the tubing of the pump.
If you can see where the equipment is broken or where the leakage is coming from: close the clamp between the catheter and the point of leakage. If there is no clamp, use the hemostat clamp, as your healthcare team has taught you, or bend the catheter in half and keep it folded in place with tape.
If you do not see where the leakage is coming from or where the equipment is broken: put a gauze compress on the dressing to absorb the leakage.
Immediately contact your healthcare team.

Child with an implantable chamber catheter (eg, Port-a-Cath®): pain or swelling at the site of insertion of the reservoir during the administration of the solution or irrigation

Possible cause(s)

Disconnection from the implantable chamber of the catheter
Displacement of the catheter
Displacement of the noncoring needle

What to do?

If your child uses an elastomeric infusion pump:
- close the catheter tubing clamp and the pump tubing clamp.
If your child uses an ambulatory infusion pump:
- press the “STOP/START” button on the pump or close the pump as indicated;
- close the clamp of the catheter tubing and the tubing of the pump.
If during irrgation:
- close the clamp of the catheter tubing,
- stop attempting to flush the line.
Immediately contact your healthcare team.

Pain in the ear, throat, neck, armpit (under the arm) or shoulder on the same side of the catheter

Possible cause(s)

Accidental displacement of the catheter

What to do?

Immediately contact your healthcare team.

Particular odor or a strange taste reported by your child during irrigation

Possible cause(s)

Contact between the saline solution and the plastic of the syringe may activate your child’s sense of taste and smell

What to do?

This is commonly reported. There is no danger to your child’s health.
If the taste is very intense, contact your healthcare team.

Unusual sound heard by your child on the catheter side during irrigation of the catheter or administration of medication with or without: pain in the ear, throat pain

Possible cause(s)

Displacement of the internal (inside the body) portion of the catheter

What to do?

Close the clamp of the catheter tubing.
Stop attempting to flush the line.
Immediately contact your healthcare team.

Swelling in the neck, face or in the arm on the same side of the catheter; pain in the armpit (under the arm)

Possible cause(s)

Phlebitis of the vein (irritated vein)
Blood clot in the vein with the catheter

What to do?

Immediately contact your healthcare team.

Presence of air bubbles or particles in the medication bag, cassette reservoir or elastomeric infusion pump

Possible cause(s)

Contamination of the solution
Problems in the preparation

What to do?

Do not administer the medication.
Contact your pharmacy or healthcare team quickly.

Medication administration time longer than usual

Possible cause(s)

Medication too cold
If using an elastomeric infusion pump and it is placed lower than the catheter insertion site
Malfunction of ambulatory infusion pump
Displacement of the catheter
Partial obstruction of the catheter

What to do?

A cold solution can also cause headaches or chills.
Irrigate the catheter with the saline solution. Refer to steps 5 and 8 to 12 of the “Catheter irrigation” method of care.
If your child uses an elastomeric infusion pump:
- make sure the medication is at room temperature. A solution that is too cold increases the time it takes for the drug to flow;
- place the elastomeric infusion pump at the same height as the catheter insertion site.
If the problem persists, contact your healthcare team promptly.

Inadvertent disconnection of the needleless connector or the pump tubing

Possible cause(s)

Accident
Mishandling

What to do?

If your child uses an elastomeric infusion pump:
- close the catheter tubing clamp and the pump tubing clamp.
If your child uses an ambulatory infusion pump:
- press the “STOP/START” button on the pump or close the pump as indicated;
- close the clamp of the catheter tubing and the tubing of the pump.
Immediately contact your healthcare team.

Ambulatory infusion pump alarms

Possible cause(s)

Various

What to do?

Close the clamp of the catheter tubing and the clamp of the pump tubing.
Press the “STOP/START” button to stop the alarm or as indicated.
Look at the message displayed on the screen.
Follow the instructions accordingly.
If necessary, consult the pump instructions you have been given.
If you still can not resolve the problem, contact your healthcare team.

Leakage of the elastomeric infusion pump or bursting of the balloon

Possible cause(s)

Breakage of the portable infusion device
Technical defect of the device

What to do?

Close the clamp of the catheter tubing and the tubing of the pump.
Disconnect the catheter from the infusion pump.
Irrigate the catheter with the saline solution. Refer to steps 5 and 8 to 12 of the “Catheter irrigation”.
Contact your healthcare team quickly.

Do not hesitate to refer to your child’s healthcare team for any questions or for specific advice related to your child’s condition.

Everyday tips

Clothing

As the tubing can easily wrap around your child’s neck or arm, keep the tubing underneath the child’s clothing.
If your child is wearing one-piece pajamas or a “onesie”, place the tubing inside the garment and pull it out through the bottom or the opening at the feet; this will prevent the tubing from wrapping around your baby’s neck.
If your child is older, keep the tubing underneath clothing; in young children, run the tubing underneath a snug-fitting undershirt so that the child is less likely to touch the tubing.

Bathing and swimming

Avoid getting the dressing wet because it may fall off. Bathing in shallow water is preferable to a shower.
To protect the dressing from splashing, cover it with waterproof plastic wrap (eg, saran-wrap™) attached with tape so that the dressing stays dry.
Never put the catheter or dressing in the bath water, even if it has been covered in plastic.
Swimming is not permitted if your child has a short peripheral catheter, a central peripherally inserted catheter (“PICC line”), a central tunnel catheter (eg, Broviac®) or an implantable chamber catheter with the needle in place; otherwise, the dressing may become wet and peel off. If the catheter is not protected, it may come out or become infected.
Your child can bathe and swim if he/she has an implantable chamber catheter (Port-a-Cath®) and the needle is not in place.

Sleeping

If your child uses an ambulatory infusion pump, place the pump beside your child in bed. Discuss the most appropriate place with your healthcare team.

Nutrition and hydration

Talk to your healthcare team about your child’s diet and hydration recommendations, based on their health status.

Activities

Your child can continue his regular daily activities (eg, writing, brushing teeth, etc) but must avoid:
- activities causing significant sweating; the dressing could fall off,
- activities which may cause accidental displacement of the tubing and the catheter (eg, gymnastics, contact/competition sports),
- the use of scissors near the catheter and tubing,
- close contact with pets who may chew the tubing or the infusion pump,
- lifting heavy objects with the arm where catheter is placed,
- bathing/swimming (unless your child has an implantable chamber catheter (eg, Port-a-cath®) and the noncoring needle is not in place).
If your child’s healthcare team agrees, your child can return to school. Notify your school’s staff of your child’s treatment and care as needed.

Travel and transportation

Avoid exposing the pump and tubing to hot or cold temperatures. In cold weather, keep the pump and tubing under clothing and have your child wear a warm coat.
Use a cooler to store medication and a padded bag to store equipment, including the “troubleshooting kit” described below.
When traveling by plane, keep all medication and equipment with you in the cabin. Request a letter from your child’s healthcare team which explains your child’s healthcare condition and need for medications.
Healthcare travel insurance is recommended; check your existing policies or purchase insurance so your child is covered in the case that a medical issue comes up while traveling. Always have a “troubleshooting kit” on hand while your child is on IV treatment; take this on any trips away from home. The kit should contain the following items:
- needleless connector
- extension tubing
- syringe pre-filled with saline solution and locking solution
- disinfecting pads
- transparent adhesive dressings
- clean gauze compresses
- adhesive tape to secure the dressing
- hemostatic clamp

Others

If your child has a peripherally inserted central catheter (PICC line), the blood pressure should be not be measured in the arm with the catheter; this might damage the catheter or the vein.

Methods of care

Methods of care : Monitoring of the catheter site

Indications

To give the antibiotic to your child, an intravenous catheter is placed in a superficial or deep vein.
The steps in the method below may serve as a guide; speak to your healthcare team about the specific equipment that your child uses.

Considerations:

This catheter requires special care to ensure proper function and prevent infections.
The catheter entry site should not change in appearance and the protective dressing should be kept clean and dry at all times.
Good handwashing is essential before and after providing care.
Optimize your child’s comfort during care with appropriate positioning and the use of distraction.

Frequency

Monitoring of the catheter site and dressing should be done:
- before and after each administration of an antibiotic with an elastomeric infusion pump or an ambulatory infusion pump operating on a discontinuous basis.
- at least once a day when changing the bag or the reservoir cassette with or without the tubing, if continuous ambulatory infusion pump is used.
- at least once a day if the catheter is not being used.
The length of the external part of the catheter must also be checked at least once a day.
Your healthcare team will advise you of the procedures for changing the dressing at the catheter entry site.

Required materials

If needed:

Adhesive tape for dressing
Transparent adhesive dressing (eg, Tegaderm®)

Refer to your healthcare team if the material used or the sequence of steps taught is different from what is described in the method of care.

Step 1: Anticipation

See the full description here

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.

Step 2: Preparation

See the full description here

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.

Step 3: Procedure

See the full description here

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.

Step 4: Position your child

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.

Why ?

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

Step 5: Check the catheter site

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.

Why ?

This step allows you to quickly detect problems.

Step 6: Check the dressing

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 healthcare team.

Why ?

This step helps you quickly identify complications.

Step 7: Check all tubing

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.

Why ?

This step helps to avoid complications.

Step 8: Check the outer length of the catheter, if applicable

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.

Why ?

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.

Step 9: Recovery

See the full description here

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.

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