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Pediatric Bone Marrow Transplant: A Guide for Families
Emergency Procedure For A Broken Or Leaking Central Line Catheter
[Home] - PBMT
Geri Quinn, RN, MSN and Janine Petitgout, RN, MA
Peer Review Status: Internally Peer Reviewed
Equipment:
- Alcohol swabs
- Sterile scissors
- Blunt needle
- Pediatric Broviac® catheter...20 gauge
- Adult Broviac® catheter...18 gauge
- Hickman® catheter...15 gauge
- Double lumen:
- 7 Fr. small lumen...20 gauge
- 7 Fr. large lumen...18 gauge
- 9 Fr. both lumen...18 gauge
- 12 Fr. small lumen...18 gauge
- 12 Fr. large lumen...15 gauge
- Sterile luerlock catheter plug
- Tongue blade
- Preservative heparin (10 u/cc)
- Clamp
- Sterile luerlock syringes with needles (2)
- 4 x 4 topper
- Tape
Procedure:
1. If the catheter breaks, leaks or cracks, it should be immediately
clamped between the child and the damaged portion of the catheter.
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2. Wash hands thoroughly.
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3. Wipe top of heparin vial with alcohol and draw up 3 cc
heparin.
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4. Change needle on syringe to appropriate size blunt
needle.
5. Wipe damaged portion of catheter with alcohol swab.
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6. Trim off damaged portion of catheter with sterile
scissors.
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7. Insert blunt needle into internal sheath of catheter.
This will form a temporary luer stub adapter.
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8. Open clamp and irrigate with heparin, clamping
catheter as last of heparin is instilled.
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9. Remove the syringe, leaving the needle in the
catheter, and attach a new catheter plug.
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10. Tape repaired section of catheter to tongue blade
padded with 4 x 4 topper. This will stabilize the repaired
section of the line so that the blunt needle cannot puncture
the catheter.
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11. Flush other port with heparin.
*Temporary repairs can only be done on single lumen and
double lumens that break before the bifurcation. If you have
a double lumen that breaks above the bifurcation (where one
lumen is divided into two), you cannot do a temporary
repair. Just clamp the line and call your physician. You
will need to come in for a permanent repair after doing the
temporary repair.
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Injection of Medications Through Central Lines - PBMT
Equipment:
- Alcohol swabs
- Syringes with 3 cc normal saline (2)
- Syringe with medication
- Syringe with 3 cc (10 u/cc) preservative heparin
- Sterile luerlock catheter cap
- Tape
Procedure:
1. Wash hands.
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2. Clean catheter connection with alcohol.
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3. Clamp catheter.
4. Remove old cap.
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5. Connect syringe with normal saline. Unclamp. Instill
saline. Clamp. Remove syringe.
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6. Connect syringe with medication. Unclamp. Instill
medication over designated time. Clamp catheter. Remove
syringe.
7. Connect syringe with normal saline. Unclamp. Instill
saline. Clamp. Remove syringe.
8. Connect syringe with heparin. Unclamp. Inject heparin,
clamping catheter as last of 3 cc is instilled.
9. Remove syringe and wipe catheter with alcohol swab.
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10. Attach new cap.
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11. Tape catheter cap in place.
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Title
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