What should I tell my doctor about before my procedure?
It is important to tell your doctor about all allergies or hypersensitivity
(undesirable reactions) to materials you know about.
What are the risks of the procedure?
The potential risks of the procedure are as follows:
•
Blockage of blood flow by air (Air Embolism)
•
Bleeding
•
Injury to nerves that connect the spine to the shoulder, arm and hand
(Brachial Plexus Injury)
•
Irregular heartbeat (Cardiac Arrhythmia)
•
Fluid collection in the sac surrounding the heart (Cardiac Tamponade)
•
Catheter or cuff breaking through skin (Catheter or Cuff Erosion
Through Skin)
•
Blockage of blood flow by a piece of the catheter (Catheter Embolism)
•
Catheter blockage (Catheter or Cuff Occlusion)
•
Catheter blockage due to pinching between the collar bone and upper
rib (Catheter Occlusion, Damage or Breakage due to Compression
Between the Clavicle and First Rib)
•
Life-threatening infection from catheter (Catheter-related Sepsis)
•
Inflammation of the inside of the heart typically due to infection
(Endocarditis)
•
Infection where catheter comes out of skin (Exit Site Infection)
•
Cell death where catheter comes out of skin (Exit Site Necrosis)
•
Leakage of fluid into surrounding area (Extravasation)
•
Hard tissue forming around device (Fibrin Sheath Formation)
•
Collection of blood outside of a blood vessel (Hematoma)
•
Blood collection around a lung (Hemothorax)
•
Fluid collection around a lung (Hydrothorax)
•
Body rejects or reacts to implant (Intolerance Reaction to Implanted
Device)
•
Cut or tear in blood vessels or organs (Laceration of Vessels or Viscus)
•
Damage to heart muscle (Myocardial Erosion)
•
Hole forms in blood vessels or hollow organs (Perforation of Vessels or
Viscus)
•
Collapsed lung (Pneumothorax)
•
Movement of catheter to the wrong position, which may keep it from
working (Spontaneous Catheter Tip Malposition or Retraction)
•
Blunt or penetrating trauma to ducts (Thoracic Duct Injury)
•
Blockage of blood flow by a blood clot (Thromboembolism)
•
Blockage of blood flow by a blood clot in a vein (Venous Thrombosis)
•
Formation of a blood clot inside the heart (Ventricular Thrombosis)
•
Blood vessel damage (Vessel Erosion)
•
Risks normally associated with local and general anesthesia, surgery,
and post-operative recovery
What are the potential benefits of Hickman™, Leonard™, and
Broviac™ Central Venous Catheters?
Central Venous Catheters are long term access devices. They can infuse
fluids, blood products, drugs, and nutrition solutions, as well as be used for
blood withdrawals. These catheters allow direct access to your veins to provide
treatment that you need.
What are some of the warnings and precautions of the
Hickman™, Leonard™, and Broviac™ Central Venous Catheters
that I should be aware of?
Only qualified healthcare practitioners should insert, manipulate, and remove
these devices.
•
Do not grasp the catheter with any instrument that might sever or
damage the catheter.
•
Do not use scissors or any sharp-edged instruments as they could
damage the catheter.
Precautions:
When the catheter is used, the user should have clean hands and wear gloves.
The hub (connection end) of the catheter should be cleaned before attaching
any tubing or syringes. Povidone iodine can be used to clean the catheter.
Acetone and tincture of iodine should not be used. It is ok to use swabsticks
with 10% acetone and 70% isopropyl alcohol to clean the skin for dressing
changes.
Only catheter accessories and components with luer lock connections should
be used to access the catheter. Syringes smaller than 10ml should not be
used.
A complete list of warnings and precautions for the Hickman™, Leonard™,
and Broviac™ Central Venous Catheters can be found in the "Instructions
for Use", which is located at eifu.bd.com. Your doctor will help you determine
whether a Hickman™, Leonard™, or Broviac™ Central Venous Catheter is
right for you.
Life After Your Medical Procedure
What is there to expect during recovery?
After your catheter is placed, you may notice bruising or feel some pain or
swelling around the insertion site. You may notice a small cuff beneath your
skin on the catheter. This helps keep the catheter in place.
There may be stiches, tape, or a clear dressing over the insertion site. The
clear dressing will need to be changed a few days after your procedure. After
that, your doctor or nurse will let you know how often the dressing will need
to be changed. If the dressing becomes soiled (dirty or wet), then it is time to
change it.
It is important to relax for the rest of the day following your procedure. Wear
loose clothing or clothes with a front opening so you can easily access your
catheter. Avoid wearing a tight bra or carrying a purse or bag across your
chest until the exit site has healed.
Contact your doctor or nurse right away if you notice the following:
•
Fever, with or without chills
•
Trouble breathing, with or without dizziness
•
Sudden onset of chest pain
•
Swelling of the face, neck, arm, or chest
•
Heavy bleeding from the catheter site that does not stop (apply pressure
to the site with sterile gauze while waiting for help)
What is the lifetime of the Hickman™, Leonard™, and Broviac™
Central Venous Catheter?
The Hickman™, Leonard™, and Broviac™ Central Venous Catheters are
intended for long term use. The catheter may stay in place until it is no longer
needed or until your doctor wants to replace it.
Living with a Central Venous Catheter
You will still be able to do most activities with a catheter. There are some
things you should be careful of. Avoid activities that could tug or pull on your
catheter. Don't go swimming or bathing if the catheter would be soaked in the
water, as the catheter should not be submerged. When getting dressed and
undressed, be aware of where the catheter is so that it does not get pulled.
After your catheter is placed, it is important to look at the catheter site every
day. If you notice any redness or irritation, or if the catheter looks like it is
broken, leaking, or has moved or lengthened, be sure to contact your doctor
right away. Do not use the catheter without notifying your doctor.
If your catheter accidentally comes out of your body, apply pressure to the
area right away and contact emergency services.
Catheter Care and Maintenance:
Catheter Damage
If the catheter or connection is damaged or comes out after your procedure,
immediately clamp the catheter using the catheter clamp or kink (bend) the
catheter and tape it. The catheter needs to be kinked so that fluid cannot
come out of it and air cannot go into it. The catheter will need to be repaired
as soon as possible, so let your doctor know right away. There are repair kits
made specifically for the Hickman™, Leonard™, and Broviac™ Catheters.
Site Care
Supplies you will need:
•
Sterile gloves (if required)
•
3 Alcohol swabsticks
•
Hydrogen peroxide
•
Sterile cotton-tipped applicators
•
3 Povidone iodine swabsticks
•
Povidone iodine ointment packet
•
Tape
•
1 Sterile cover dressing (transparent or tape)
•
1 Alcohol wipe
•
1 Sterile 2 in. x 2 in. (5 cm x 5 cm) gauze dressings
•
1 Sterile pre-cut 2 in. x 2 in. (5 cm x 5 cm) gauze dressings
1.
Clean the work surface by wiping with a paper towel that has been
moistened with alcohol. Wipe dry or allow to air dry. Then place supplies
on the cleaned surface.
2.
Wash your hands thoroughly using warm soapy water. Rinse completely
and dry using a clean towel or fresh paper towels.
3.
Carefully open the dressing kit, or unwrap supplies, without touching the
inside surfaces of the kits or wrappers.
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