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Central Line Associated Bloodstream Infection
WHAT YOU NEED TO KNOW:
A 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.
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- Medicine may be given to help treat the infection or decrease pain or fever.
- Removal or change of a central line may be needed to help get rid of the infection.
- Blood tests may show infection and give information about your overall health. Blood tests may also show what germ is causing the infection.
- A culture of the central line may show what germ is causing your illness. This is done after the central line is removed.
- An x-ray, ultrasound, CT, or MRI may show infection in other areas of the body. You may be given contrast liquid to help the organs show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
What healthcare providers do to prevent CLABSI:
- Use sterile technique to insert a central line. Healthcare providers will do the following when they insert a central line:
- Wash their hands with soap and water or an alcohol based hand rub.
- Put on a mask, cap, sterile gloves, and a sterile gown before they insert a central line. They will cover your body with a sterile sheet. They will leave an opening over the area where the central line will be inserted.
- Clean the skin and allow it to fully dry before they insert a central line.
- Use an ultrasound to help insert a central line. This may decrease the number of needle sticks and the risk for a CLABSI.
- Choose an area for a central line that has a low risk for infection. Healthcare providers will try to use areas with less risk for infection such as the chest or arm.
- Use central lines and bandages with antibiotics in them. Healthcare providers may insert catheters with antibiotics in the catheter to decrease your risk for a CLABSI. They may also use a bandage that has an antibiotic.
- Remove a central line as soon as possible. Healthcare providers will take out a central line when you no longer need it.
- Care for the catheter after insertion. Healthcare providers will do the following when they care for a central line:
- Wash their hands before and after they touch any part of the central line.
- Clean the skin at and around the insertion site as directed.
- Clean the caps on the end of the central line before and after medicine is given.
- Change the caps and tubing every 72 hours.
- Change the dressing when it becomes wet, dirty, or comes off.
- Flush the central line when it is not being used as directed.
- Secure your central line. This may prevent the central line from moving out of place.
- Monitor the central line insertion site. Healthcare providers will monitor the insertion site every day for signs of infection.
- Bathe patients with chlorhexidine. Healthcare providers may bathe all patients in a critical care, or intensive care unit, with a special soap. This may decrease the risk of germs on your skin from getting into your bloodstream through your central line.
What patients can do in the hospital to prevent a CLABSI:
- Ask all healthcare providers to wash their hands. Ask your healthcare provider to wash his hands before and after he touches your central line, tubing, or connections.
- Ask why your central line is needed and for how long. A central line should be removed as soon as it is no longer needed.
- Tell a healthcare provider if your bandage becomes wet, dirty, or falls off. A new bandage should be applied over your central line to prevent infection.
- Tell your healthcare provider if you see cracks or drainage from your catheter. Tell your healthcare provider if you see fluid coming from your insertion site or any part of the tubing. Also tell him if you feel pain when he flushes your catheter or at the insertion site.
A CLABSI may be difficult to treat. A CLABSI may spread throughout and your body and cause other infections such as endocarditis, osteomyelitis, or an epidural abscess. A CLABSI may lead to sepsis or septic shock. Sepsis may cause organs to stop working correctly. Septic shock may happen if sepsis gets worse. Multiple organs may shut down or be permanently damaged. This may be life threatening.
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