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TRANSPARENT MEMBRANE DRESSING |
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Change immediately if:
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Loose, not occlusive, moisture accumulation, drainage, redness, or irritation.
Initial dressings will be changed PRN if saturated, and 24-48 hours post insertion of midlines, PICCs, and CVADs if there is gauze present under the dressing or drainage is noted. |
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Peripheral |
With site change. |
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Midline |
Every 7 days. |
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PICC or CVAD |
Every 7 days. |
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Implanted port |
With every non-coring safety needle change. |
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GAUZE DRESSINGS |
Every 48 hours. |
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NEEDLELESS CONNECTOR |
On admission change connector to type used in facility. |
Integrity of valve/diaphragm is influenced by frequency of use, fluid composition, & viscosity. Change needleless connector immediately if compromised. |
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Routine meds/fluids |
Weekly. |
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Parenteral Nutrition |
Every 96 hours. |
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If there is blood in the cap |
Immediately. |
eg.: Post labs/transfusion/back-flow of blood. |
EXTENSION TUBING
(with clamp) Add to any external catheter that has no clamp (except Groshong & similar valved catheters) |
If extension set is added as part of original central venous access device insertion procedure under sterile conditions, it may be considered a permanent part of the catheter and changed only if contaminated or damaged. Sets added post-insertion are changed weekly or PRN. |
Use air embolism precautions if indicated. |
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INFUSION TUBING |
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Continuous |
Every 96 hours. |
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Intermittent |
Every 24 hours. |
Any tubing disconnected between infusions. |
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Parenteral Nutrition Infusion
Lipids only infusion
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Every 24 hours.
Every 12 hours. |
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Secondary |
With primary tubing. |
Do not disconnect from primary tubing between doses.
Back-prime tubing from primary by holding the secondary bag below the level of primary bag until drip chamber on secondary tubing is 1/3-1/2 full. |
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FILTERS |
Change with IV tubing. |
Use air-eliminating type. |
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0.22 micron |
Routine meds/fluids. Parenteral nutrition if NO LIPIDS in bag. |
Completely bacteria retentive. Fat molecules too large for 0.22 filter. |
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1.2 micron |
Parenteral nutrition/lipids in bag. |
Removes precipitates that may be masked by lipid emulsion. |
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No filter |
Lipids infused alone.
(1.2 micron also acceptable.)
Medications that cannot be filtered. |
May be Y-sited below 0.22-micron filter of TPN tubing. |
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SOLUTION CONTAINER |
Within 24 hrs after being spiked. |
Inspect bag; verify label and expiration date prior to hanging. |