Changing a central line dressing at home, step by step

This page walks patients and caregivers through a central line dressing change at home. It starts with the signs that mean you should call for help, then explains the dressing and each 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. Neither is something to wait out at home. Do not drive yourself.

Call 911 or go to the nearest emergency department if there is a lot of bleeding at the site, or the bleeding will not stop.

Call your care team right away, day or night, for a temperature of 100.4°F (38°C) or higher, chills, or any other sign of infection. The CDC says to call your doctor immediately for a temperature of 100.4°F or higher during cancer treatment. It says fever may be the only sign of infection, and an infection during chemotherapy can be life-threatening. Do not wait for a fever if you have chills or feel unwell. A normal temperature is not a reason to wait. Go to an emergency department if nobody answers within a few minutes.

Call your care team right away if you have pain where the tube goes into your skin, or you see bleeding, redness, swelling or leaking there (CDC). Also call right away if the catheter looks cut or cracked, seems blocked, or is coming out of the vein.

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. 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. 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.
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.

The steps are simple on paper, but doing them yourself takes practice. 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.

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 your care team right away before you cover it up.

• MedlinePlus — Central venous catheter: dressing change