By Dr. Tauhidul Alam Choudhury, Nephrology
There are two types of vascular catheter for Dialysis:
- It usually lasts for shorter duration.
- It can be placed jugular, subclavian or femoral veins.
- It may be double or triple lumen.
B. Tunneled cuff catheter:
- They lasts longer usually more than six months and even more than 2 years.
- It is very soft catheter.
- One cuff in the catheter prevents infection by getting fibrosis.
- It is more costlier.
- Catheters can be used for dialysis immediately after placement.
- A catheter may be used when one must begin dialysis before a fistula or graft has time to mature.
Concerns with catheters include:
- Greater likelihood to become infected, clotted or fail
- Slower blood flow, so dialysis may not clean the blood as thoroughly as with a fistula or graft
Inferior access for long-term HD Cares to prevent from infections and for catheter patency:
- Wash hands before you touch any part of catheter or catheter exit site (area on your skin where the catheter goes into your body).
- Keep the clamps on your catheter tubes closed unless the catheter is being used.
- Rinse out (flush) the catheter as often as advised. This can help prevent blood clots.
- Keep the area around the catheter exit site clean and dry at all times. This may mean you cannot swim, take showers or soaking baths. You will need to carefully wash without getting your unhealed catheter exit site wet.
- Change the dressing over your catheter incision as often as your doctor tells you to.
- Do not get the area around the catheter incision wet.
- Look for signs of infection, such as: redness , discharge, fever or pus coming
- Do not let anyone draw blood from your catheter.
Protect your catheter
- Do not pull on or tug catheter, or Do not remove protective dressing.
- Take care to be gentle around your catheter when getting dressed and undressed or removing a blanket or covering.
- Always keep sharp instruments, such as scissors, away from your catheter.
- Keep an emergency dressing kit at home.
- Never open your catheter to the air
The Role of the Dialysis Caregiver:
- Always wear a mask covering is nose and mouth while being accessed
- Always wash their hands and wear clean gloves when caring for your access If, antiseptic handwash (e.g. chlorhexidine) used, wait for 60-90 seconds or till dry-up
- Cleaning and dressing of the access during each treatment
When to call doctor?
If there is redness, fever, riggers and bleeding from site. If catheter is pulled out or bleeding occurs, put pressure locally for few minutes. bleeding will stop and call for the doctor or dialysis team.