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Central Line Associated Bloodstream Infection
A central line-associated bloodstream infection (CLABSI)
happens when germs get into the bloodstream through a central line. A central line, also called a central venous access device (CVAD), is a special IV catheter. It is inserted into a large vein in the neck, chest, arm, or groin. The tip of the catheter sits close to the heart. It is usually left in place for an extended length of time. The CVAD can be used to give medicine, fluid, or draw blood. It can also be used for dialysis or to give nutrition. A CLABSI is often serious and caused by bacteria or a virus.
Common symptoms include the following:
- Pain, redness, swelling, or pus where the catheter was inserted
Call 911 for any of the following:
- You feel lightheaded, short of breath, and have chest pain.
- You cough up blood.
- You have trouble breathing.
Seek care immediately if:
- Blood soaks through your bandage.
- Your heart feels like it is beating faster than normal.
- You feel dizzy or faint.
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
Contact your healthcare provider if:
- You have a fever or swelling, redness, pain, or pus where the catheter was inserted.
- Your symptoms do not get better after treatment.
- You cannot flush your central line, or you feel pain when you flush your central line.
- You see a hole or crack in the tubing of your central line.
- You run out of supplies to care for your central line.
- You have questions or concerns about your condition or care.
Treatment for a CLABSI
may include removing or changing your central line. You may need any of the following:
- Antibiotics help treat a bacterial infection.
- Acetaminophen decreases pain and fever. Taking too much acetaminophen can hurt your liver. Read labels so that you know the active ingredients in each medicine that you take. Talk to your healthcare provider before taking more than one medicine that contains acetaminophen. Ask your healthcare provider before taking over-the-counter medicine if you are also taking pain medicine prescribed (ordered) for you.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine or have kidney disease, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
- Take your medicine as directed. Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Prevent a CLABSI:
- Limit contact with your central line. Only touch your central line when you need to give yourself medicine or clean it. Do not let others touch your central line or tubing.
- Wash your hands before and after you touch your central line. Use soap and water or an alcohol-based hand rub. Tell others to wash their hands before and after they visit to decrease the number of germs around you.
- Keep the tubing clamped when not in use. Ask your healthcare provider how to use a clamp.
- Change your central line bandage as directed. Change your bandage once per week or as directed. Change the bandage any time it becomes wet, dirty, or dislodged. Keep the central line covered with a bandage at all times. Use a semipermeable, sterile gauze, or transparent bandage as directed.
- Clean your central line and skin as directed. Clean your skin every time you change your bandage. Follow directions from your healthcare provider about how to clean your central line and the skin around it. You may need another person to help you. The following is an overview for you or someone who helps you:
- Wash your hands and put on gloves and a mask. If someone else is helping you, both you and that person need to wear a mask.
- Remove the old bandage. Remove your gloves and throw them away.
- Wash your hands or use an alcohol based hand rub. Put on sterile gloves.
- Use a cleaning solution to clean the insertion site and skin around it as directed.
- Clean the tubing that comes out of your skin as directed.
- Apply a bandage as directed. If the bandage is clear, make sure you can see the area where the central line goes into your skin.
- Change and clean the caps and tubing as directed. You may need extra tubing to get your medicine. Ask your healthcare provider when and how to change the tubing and caps. Clean the caps before and after each use as directed.
- Secure your central line as directed. This will help prevent your central line from moving. It may also prevent damage to your skin that could lead to an infection.
- Flush your central line as directed. You may need to flush your central line before and after use with medicine or saline. Ask your healthcare provider how to flush your central line.
- Check your central line every day for signs of infection. Look for redness, swelling, pus, or fluid. Report any pain at the insertion site or signs of infection to your healthcare provider right away.
Follow up with your healthcare provider as directed:
Write down your questions so you remember to ask them during your visits.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.