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Central Line Associated Bloodstream Infection


What is a central line-associated bloodstream infection (CLABSI)?

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.

What increases my risk for CLABSI?

  • Being very young or very old
  • A critical illness such as sepsis, major trauma, surgery, burns, or a long hospitalization
  • A weak immune system or a chronic condition such as cardiovascular disease or kidney disease
  • A central line inserted emergently into the groin or left in place for longer than needed
  • Receiving certain medicines or treatments such as IV nutrition through your central line

What are the signs and symptoms of CLABSI?

  • Fever
  • Chills
  • Pain, redness, swelling, or pus where the catheter was inserted

How is CLABSI diagnosed?

Your healthcare provider will look at your central line insertion site. He may ask you about your symptoms. Blood tests will be done to find out if your symptoms are caused by an infection. Blood tests or a culture of your central line may also show what germ is causing your infection.

How is CLABSI treated?

  • Removal or change of your central line may be needed to help get rid of the infection.
  • Medicines will be given to treat an infection or decrease pain and fever.

How can I help prevent 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.

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.

When should I seek immediate care?

  • 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.

When should I contact my healthcare provider?

  • 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.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.