Dialysis Line Dressing

Dialysis catheters (temporary or tunnelled) require strict aseptic dressing management to prevent infections (e.g., CLABSI) and maintain patency.

1. Types of Dialysis Catheters

2. Dialysis Catheter Dressing Protocol

Supplies Needed:

✔ Chlorhexidine (2%) or povidone-iodine
✔ Sterile gloves, mask, drape
✔ Transparent semi-permeable film (e.g., Tegaderm™)
✔ Sterile gauze (if exudate present)
✔ Antimicrobial ointment (if institution protocol)

Step-by-Step Dressing Change:

1. Hand hygiene + sterile gloves.
2. Remove old dressing (peel toward catheter to avoid dislodgment).
3. Inspect site for:

• Erythema, pus, tenderness (signs of infection)
• Catheter integrity (cracks, leaks)

1. Clean site with chlorhexidine (circles, outward motion).
2. Apply antimicrobial ointment (if ordered, e.g., bacitracin).
3. Cover with transparent film (or gauze + tape if exudate).
4. Secure catheter (avoid tension/kinking).
5. Label with date, time, and initials.

3. Key Maintenance Practices

✅ Frequency:

• Change every 7 days (or sooner if loose/soiled).
• Post-dialysis inspection for blood leaks.

✅ Hygiene:

• No submerging in water (use waterproof covers for showers).
• Avoid touching the catheter hub (sterile caps always on).

✅ Flushing/Locking:

• Heparin lock (1000 U/mL) post-dialysis to prevent clots.
• Never infuse fluids outside dialysis (risk of infection).

4. Complications & Management

5. When to Remove the Catheter?

• No longer needed (e.g., mature fistula/graft).
• Unresolved infection (persistent bacteremia).
• Catheter malfunction (fibrin sheath, thrombosis).

Removal Steps:

1. Supine position, sterile field.
2. Remove sutures, apply pressure while pulling.

Cover site with occlusive dressing × 24 hrs.