Canterbury DHB

Context

Catheter Care

See CDHB CVAD resource book.

Blood Sampling

Routine blood samples from inpatients on the BMTU will be taken on Mondays, Wednesdays, and Fridays if the patient is stable and well, e.g. afebrile. Each day, the doctor who has reviewed the patient will indicate on the whiteboard template any tests for the following morning.

Ethanol Locks

Ethanol locks are instilled into each lumen of the Hickman® catheter on Tuesdays and Fridays. These are left in for 2 hours then removed. Ethanol locks have been shown to reduce catheter-related infection. Ethanol helps maintain catheter patency especially when PN has been administered.

Ethanol Treatment

Tunnelled catheters are an essential part of treatment of patients undergoing chemotherapy for haematological disease or Bone Marrow Transplant.

Catheter-related sepsis is an important complication of tunnelled central venous catheters.

Up to 40% of neutropenic patients experience at least one episode of bacteraemia, much of which is attributed to catheter-related sepsis and represent a major hazard to the patient.

Ethanol is effective against a wide range of micro-organisms, including Staphylococcus aureus, Coagulase negative staphylococci, Streptococci, Escherichia coli, Pseudomonas aeruginosa and Candida albicans.

Two hours of contact is required to kill organisms in the biofilm. Ethanol locks of up to 4 hours may be necessary for biofilms that have been present for more than 1–2 days. For prophylaxis (in-patients only) an ethanol lock, 2 mL of 70% ethanol, is inserted into each lumen and left for at least 2 hours on Tuesdays and Fridays. If there is a line infection the same amount of ethanol is placed down each lumen daily for as long as the patient is receiving IV antibiotics. It is left in the line for 2-4 hours.

Ethanol locks can only be used with silicon catheters.

About this Canterbury DHB document (5038):

Document Owner:

Sean Macpherson (see Who's Who)

Issue Date:

January 2019

Next Review:

January 2022

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5038