How to Use a Dialysis Catheter As a Line
The kidneys remove waste and excess water from the body. When the kidneys fail, dialysis is done to prevent accumulation of toxins in the blood. A large catheter with two ports is inserted in the patient's neck, chest or groin for vascular access. Blood flows from the patient's body through one catheter port to the dialysis machine, where it is cleaned and filtered, and returns to the patient through the other port. Although it is not common practice, the dialysis catheter may be used to deliver intravenous (IV) medications when other means of vascular access are unavailable.
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Things You'll Need
- Gloves
- 2 Alcohol pads
- Sterile 10cc syringe
- IV medication bag with tubing attached
Instructions
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Accessing the Dialysis Catheter
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1
Wash hands and don gloves.
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2
Use either port of the catheter to infuse medicine; hold the port with your thumb and forefinger. With your other hand, use an alcohol pad to wipe the port clean. Do not let go of the port or it will become contaminated when it touches the patient's skin or clothes.
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3
Use your free hand to connect the syringe to the port. Draw back 10cc of blood; this blood contains heparin, which keeps the line patent. Lay the syringe on the bed or another flat surface.
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4
Clean the port again with another alcohol pad. Attach the IV tubing to the port, and program the IV pump. Discard the 10cc syringe in the red biohazard box.
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5
Disconnect the tubing when you are done infusing the medication. Flush the catheter with 10cc of saline and heparin to keep the line open.
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1
Tips & Warnings
It is essential that you waste 10cc of blood prior to using the dialysis catheter. Heparin, a blood thinner, keeps the line from clotting. Using the catheter without first pulling back 10cc of blood will send a mega dose of heparin into the patient's bloodstream, which can cause profuse bleeding and possible death.
Dialysis catheters clot easily, and at many institutions they are handled exclusively by the dialysis nurse. In emergency cases, such as tumor lysis syndrome where cells burst after chemotherapy and release massive amounts of potassium into the bloodstream, dialysis must be done immediately to get rid of excess potassium or lethal heart irregularities can occur. The catheter is essentially the patient's lifeline. If it becomes clotted, dialysis cannot take place; the catheter must first be declotted (dissolving the clot to allow the flow of fluids), or another catheter must be inserted into the patient. Both options require time, which is unavailable in dire situations. If you use the dialysis catheter, make sure you flush with heparin when you are done to keep it patent.
