I'm seeking guidelines and best practice for handling situations in which a central line hub is exposed (due to needless injection cap falling off, or being removed inadvertently by the patient etc.). Are there timeframes regarding how long a hub can be exposed before significant infection risk occurs?
Our home care agency has had 2 situations recently. One adult PICC patient whose hub was exposed for 1 hour (before nurse arrived for visit). Another pediatric Broviac hub exposed for 12 hours. In both situations the integral catheter clamp was closed when hub exposure occurred.
Appreciate the input.
Paula
No studies have examined this issue and therefore no guidelines have been established. Obviously you should work to ensure this NEVER happens. Infection is NOT my main concern. Air embolism is a very high risk and the #1 priority for prevention of this dangerous situation. I hope you are teaching patients to clamp all CVAD extension legs after each use.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thanks Lynn,
We are certainly teaching patients to clamp CVAD extension legs after each use, as you recommended. These two occurences were the first I have encountered since coming to home care almost a year ago.
I appreciate your input.
Paula