Changing a central line dressing at home, step by step

Call 911 if you suddenly cannot catch your breath or you feel faint. Shortness of breath and dizziness are listed as reasons to get medical help when you have a central line, and neither is something to wait out at home.

A fever or chills needs your care team immediately, at any hour. A line infection can move fast, and CDC treats a fever during cancer treatment as a medical emergency. Go to an emergency department if nobody answers within a few minutes.

Call your care team the same day if you have pain where the tube goes into your skin, or you see bleeding, redness or swelling there. Also call the same day if the catheter looks damaged, or if it seems blocked.

A central venous catheter is a tube that goes into a vein in your chest or neck and ends at your heart. It is used to give medicines, to give nutrition, or for dialysis. Blood can also be drawn from it, which saves you needle sticks.

Because one end of the tube sits deep inside a large vein, the small opening in your skin has to stay protected. That is the whole job of the dressing.

The usual schedule is about once a week.

You do not wait for that day if something goes wrong with the bandage. Change it when it becomes loose, when it gets wet, or when it gets dirty.

A loose or damp dressing is not a small problem — it is the reason to do the change early.

Your team gives you a supply kit. It contains:

• sterile gloves
• a cleaning solution
• a special sponge
• a Biopatch
• a clear barrier bandage, such as Tegaderm or Covaderm

Before anything else: use the exact supplies and the exact method your nurse or vascular access team showed you. MedlinePlus is explicit that you should follow your provider's instructions, and kits, dressing types and flush routines differ between services and between line types. What follows describes the shape of the job so it is less unfamiliar the first time. It does not replace the demonstration, and if you have not had one, ask for it rather than working from a page.

1. Wash your hands well with soap and water for 30 seconds. This is not a quick rinse. It is the single step that protects the site most.
2. Set up. Lay a fresh paper towel down on a clean surface and put your supplies on it.
3. Put on clean gloves and take the old dressing off.
4. Put on the sterile gloves. Now look closely at the site. You are checking for redness, swelling, or any bleeding or other drainage.
5. Clean the skin with the sponge and the cleaning solution, then let it air dry.
6. Put the new Biopatch on with the grid side facing up.
7. Cover it with the clear barrier bandage.
8. Write down the date you did the change.

That last step matters more than it sounds. It is how you and your nurse both know when the next one is due.

Almost nobody feels confident the first time. Ask to be walked through a change in clinic, and then ask to do one yourself while a nurse watches. Many people find it easier with a second person helping — one to hold supplies, one to keep sterile gloves clean.

Set your supplies out before you start, and make sure you will not be interrupted halfway through. Once the old dressing is off, you want to keep going.

If anything about the site looks different from last week, stop and call before you cover it up. A photo taken before you put the new bandage on can help your nurse see what you are describing.

• MedlinePlus — Central venous catheter: dressing change