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Appendix B
Summary of Recommended Frequency of Replacements for
Catheters, Dressings, Administration Sets, and Fluids
Please note:
An
erratum has been published for this article. To view the erratum, please
click here.
Catheter
Replacement and
relocation of device
Replacement of
catheter site dressing
Replacement of
administration sets
Hang time for parenteral
fluids
Peripheral venous
catheters
Replacement and relocation
of device
Replace dressing when the
catheter is removed or replaced, or when the dressing becomes damp,
loosened, or soiled. Replace dressings more frequently in
diaphoretic patients. In patients who have large bulky dressings
that prevent palpation or direct visualization of the catheter
insertion site, remove the dressing and visually inspect the
catheter at least daily and apply a new dressing.
Replace intravenous
tubing, including add-on devices, no more frequently than at 72-hour
intervals unless clinically indicated. Replace tubing used to
administer blood, blood products, or lipid emulsions within 24 hours
of initiating the infusion. No recommendation for replacement of tubing used for
intermittent infusions. Consider short extension tubing connected to
the catheter to be a portion of the device. Replace such extension
tubing when the catheter is changed.
No recommendation
for the hang time of intravenous fluids, including nonlipid-containing
parenteral nutrition fluids. Complete infusion of lipid-containing
parenteral nutrition fluids (e.g., 3-in-1 solutions) within 24 hours
of hanging the fluid. Complete infusion of lipid emulsions alone
within 12 hours of hanging the fluid. Complete infusions of blood
products within 4 hours of hanging the product.
Midline catheters
In adults, replace
catheter and rotate site no more frequently than every 72– 96
hours. Replace catheters inserted under emergency basis and insert a
new catheter at a different site within 48 hours. In pediatric patients,
do not replace peripheral catheters unless clinically indicated.
As above.
As above.
As above.
Peripheral arterial
catheters
No recommendation for the
frequency of the catheter replacement.
Replace dressing when the
catheter is replaced, or when the dressing becomes damp, loosened,
or soiled, or when inspection of the site is necessary.
Replace the intravenous
tubing at the time the transducer is replaced (i.e., 72-hour
intervals).
Replace the flush solution
at the time the transducer is replaced (i.e., 72- hour intervals).
Central venous catheters
including peripherally inserted central catheters and hemodialysis
catheters
In adults, do not
replace catheters routinely to prevent catheter-related infection.
In pediatric patients, no recommendation for the frequency of
catheter replacement. Replace disposable or reusable transducers at
72-hour intervals. Replace continuous flush device at the time
the transducer is replaced.
Replace gauze dressings
every 2 days and transparent dressings every 7 days on short-term
catheters. Replace the dressing when the catheter is replaced, or
when the dressing becomes damp, loosened, or soiled, or when
inspection of the site is necessary.
Replace intravenous tubing
and add-on devices no more frequently than at 72-hour intervals.
Replace tubing used to administer blood products or lipid emulsions
within 24 hours of initiating the infusion.
No recommendation
for the hang time of intravenous fluids, including nonlipid-containing
parenteral nutrition fluids. Complete infusions of lipid-containing
fluids within 24 hours of hanging the fluid.
Pulmonary artery
Do not routinely replace
catheters.
As above.
As above.
As above.
Umbilical catheters
Do not replace catheter to
prevent catheter-related infection.
Do not routinely replace catheters.
Not applicable.
Replace intravenous tubing
and add-on devices no more frequently than at 72-hour intervals.
Replace tubing used to administer blood products or lipid emulsions
within 24 hours of initiating the infusion.
No recommendation for
the hang time of intravenous fluids, including nonlipid-containing
parenteral nutrition fluids. Complete infusion of lipid-containing
fluids within 24 hours of hanging the fluid. Includes nontunneled
catheters, tunneled catheters, and totally implanted devices.
Healthcare Infection Control Practices Advisory
Committee
Membership List, May 2001
Chairman: Robert A. Weinstein,
M.D., Cook County Hospital, Chicago, Illinois.
Co-Chairman: Jane D. Siegel, M.D., University of Texas Southwestern
Medical Center, Dallas, Texas.
Executive Secretary: Michele L. Pearson, M.D., Medical Epidemiologist,
National Center for Infectious Diseases, Centers for Disease Control and
Prevention, Atlanta, Georgia.
Members: Raymond Y.W. Chinn,
M.D., Sharp Memorial Hospital, San Diego, California; Alfred DeMaria, Jr.,
M.D., Massachusetts Department of Public Health, Jamaica Plain,
Massachusetts; James T. Lee, M.D., PhD., University of Minnesota and VA
Medical Center, St. Paul, Minnesota; Ramon E. Moncada, M.D., Coronado
Physician’s Medical Center, Coronado, California; William A. Rutala,
PhD., University of North Carolina School of Medicine, Chapel Hill, North
Carolina; William E. Scheckler, M.D., University of Wisconsin Medical
School, Madison, Wisconsin; Beth H. Stover, Kosair Children’s Hospital,
Louisville, Kentucky; Majorie A. Underwood, Mt. Diablo Medical Center,
Concord, California.
Disclosure of Financial Interests or Relationships
Dennis Maki: Research grant
sponsorship from Arrow, 3M, Becton-Dickinson, Johnson and Johnson;
consultant for Micrologix. Issam Raad: Holds two patents associated with minocylcine-rifampin
catheters. Patents are the property of University of Texas M.D. Anderson
Cancer Center, Baylor College of Medicine and Wake Forest University. Both
patents are liscensed to Cook Critical Care with royalty rights to the
institutions involved, and a percentage of royalties to the inventors.
Co-inventor of patents associated with minocycline-EDTA flush solution.
These patents are not yet licensed. Becton-Dickenson holds rights to this
technology. Grant and research support from Kimberly Clark,
Becton-Dickinson, Abbott Labs, Immunomedics, and Cook Critical Care, Inc.
Stephen Heard: Research grant
sponsorship from Cook Critical Care, Inc., and Edwards Lifesciences.
E. Patchen Dellinger: Research support, lectured for honoraria, or
served on advisory boards for SmithKline Beecham, Wyeth-Ayerst, Pharmacia,
Bristol-Myers Squibb, Zeneca, Pfizer, Aventis, Hoffman-LaRoche, Arrow,
NABI, Ortho-McNeil, Park-Davis, Abbott, ICOS, Immunex, Chiron, Searle,
Ican, Inc., and Centercor.
Andrienne Randolph: Research support from Cook Critical Care.
Leonard Mermel: Research support from Arrow, Johnson and Johnson;
consultant to 3M.
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