I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Rerun on July 27, 2006, 09:57:12 PM
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They think my catheter is getting infected. They say it is red and some discharge is coming out. Hell, I never see it, so I don't know. The guy who usually changes my dressing was on break, so some other nurse did it and that was her observation. They took a culture and a blood test. No fever, and no pain. (Yet)
It has been so HOT here and I sweat very easy, so I know that is a problem because that Tegaderm doesn't breath. Plus they got a new type that has a split in it for the tubes and I hate it.
I guess I will have to go back to the fistula.
On dialysis, you are only alive as long as you have an access. (Bright Spot for the day) 8)
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I use a transparent bandage called OP-Cite to cover the catheter. It seems to breathe and is flexible. The Davita clinic I go to used to provide these but they stopped apparently to save money >:(. They now use gauze and tape to dress the catheter. That was very uncomfortable for me so I went out on the net and ordered the Op-Cite bandages myself. I take one with me each dialysis session.
Rerun, I hope your catheter is not infected!
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sometimes it can look infected but if there is no pain and you have no fever that is a good sign. Mine has looked infected but never has been. The nurse takes a swab and sends it to the lab and it has always come back clean. So ask what the results were if they swab it. Where I live things are a little different so I take care of my own catheter by daily cleaning it with Chlorhexidine. But in your case, the nurse just cleans it I assume?
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sometimes it can look infected but if there is no pain and youhave no fever that is a good sign. Mine has looked infacted but never has been. The nurse takes a swab and sends it to the lab and it has always come back clean. So ask what the results were if they swab it. Where I live things are a ltitle different so I take care of my own catheter by daily cleaning it with Chlorhexidine. But in your case, the nurse just cleans it I assume?
::) It really only takes a few seconds to re-read your post. :)
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sometimes it can look infected but if there is no pain and youhave no fever that is a good sign. Mine has looked infacted but never has been. The nurse takes a swab and sends it to the lab and it has always come back clean. So ask what the results were if they swab it. Where I live things are a Little different so I take care of my own catheter by daily cleaning it with Chlorhexidine. But in your case, the nurse just cleans it I assume?
::) It really only takes a few seconds to re-read your post. :)
Bah!! That was what the rolly eyes were for :P I should have spell checked eh? You should see how it looked before I looked it over :P But the spell check would have helped me .. actually I think I DID use the spell check .. because I just did this time and it STILL did not catch those ..
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sometimes it can look infected but if there is no pain and youhave no fever that is a good sign. Mine has looked infacted but never has been. The nurse takes a swab and sends it to the lab and it has always come back clean. So ask what the results were if they swab it. Where I live things are a Little different so I take care of my own catheter by daily cleaning it with Chlorhexidine. But in your case, the nurse just cleans it I assume?
::) It really only takes a few seconds to re-read your post. :)
Bah!! That was what the rolly eyes were for :P I should have spell checked eh? You should see how it looked before I looked it over :P But the spell check would have helped me .. actually I think I DID use the spell check .. because I just did this time and it STILL did not catch those ..
It's not just using spell check, it's looking over your post and see if there are any typos.
youhave Should be "you have"
infacted Should be "infected"
ltitle Should be "little"
I see you replied here, but didn't fix the post in question. ::)
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Play it safe with a catheter.
Don't forget that the other end of it is staring into your heart. ANY infection entering that catheter can be a very big deal.
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Play it safe with a catheter.
Don't forget that the other end of it is staring into your heart. ANY infection entering that catheter can be a very big deal.
Yes, this is why the nurses would rather use a fistula than catheters. They are high risk for infections.
It's not just using spell check, it's looking over your post and see if there are any typos.
youhave Should be "you have"
infacted Should be "infected"
ltitle Should be "little"
I see you replied here, but didn't fix the post in question. ::)
Epoman I told you before that I depend on the SpellCheck to a great deal since I am Dyslexic. I look it over and some times words that are wrong look right to me. And I did use the spell check twice and it did NOT catch the words and the third time it did catch little but still not the other two. I don't know what to tell you. I am using IE. But it still should work all the time shouldn't it? Maybe it is just me ... :-[
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Hi Rerun
When will you get the results back?.........let us know. Hope it's just the heat!
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I hope you can get your Catheters sorted out Rerun. That is one fear I have just now. Will the lines get infected. I have been having TPA in the lines the last three times. To try to clean the lines out. My pump speeds are slowing down my Venus pressure is going up. Last dialysis pump speed 220 Venus pressure 260. They are talking about trying the NEEDLE :o again. NOT HAPPY >:( The head nurse Shirley said when see comes back off holiday see is going to put a NEEDLE in my little fistula I hope by the time she gets back off her holiday she as forgot ;)
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Hi Rerun
When will you get the results back?.........let us know. Hope it's just the heat!
On Saturday they had not received the results back yet. The nurse said the received some back and that it was a good sign because apparently the preliminary results must have not shown infection or they would have called to start me on something. (Antibiotic)
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Yes, that does sound like a good sign. My father's access is always red and runny, so I asked the surgeon just what should we look out for, as far as an infection........Here is what he said..........RED is OK, RED STREAKS not a good sign. Hope your heat is better than Tennessee this week-We are in for 105 heat index till Wednesday/ ~not very comfy weather for catheters and such~ ;)
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No, Sacramento just finished an 11 day heat wave of over 105 every day and higher. I sweat like a pig (well, actually pigs don't sweat) but you know what I mean. It just runs off me. The skin under my catheter is very itchy from being damp all the time.
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It as been too hot for me in the UK the last few weeks it as been in the 90s too hot on the machine. Turned the temp on the machine down to 36c (96.80F) Usually 36.5c (97.70F) Not a lot but it made a big difference.
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it is over 100F today and I live in Canada :( This is going to be a hard day for me today :(
I still have my Catheter even though it has been over a year now. I am hoping to get mine out soon though but with my fistula still blowing a lot :( I think it will still be awhile :(
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My exit site has always been a brownish color with a little bit of gunk on it.. in the 2 years that I've had it, I've had 2 site infections.. but been lucky enough to never need antibiotics.. cleaning and changing the dressing every day seemed to do the trick... my centre just recently changed dressing protocals.. I do shower dressings now, as opposed to sterile dressings.. which is pretty cool.. with my sight problems, I couldn't do the sterile dressings myself.. but I can do the shower dressings... which means I can take a shower whenever I want, and not whenever I have someone availible to do the dressing for me...
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I have had three perm cath infections, and two catheter removals.
for me the signs of infection were as follows:
redness and swelling on the skin where the line is tunneled.
sore to touch.
oozing.
followed by extremely high fever and vomiting.
not fun I had two removed and when they wanted the third one removed me and my wife had enough of all the procedures and scars on my chest and went home determined to pray and see it healed. It worked the redness went down within half an hour. all the swelling was gone by the next morning and then my fever returned to normal, so instead of six scars on my chest I have four.
Dr's are funny one time I was awake having a tunneled line put in, when the Dr said "Oh crap" I said"what ? " He replied " I just snipped an artery Ill just have to stitch it ". >:D I wonder how many mistakes they make under general anesthetic that we don't hear about
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when they wanted the third one removed me and my wife had enough of all the procedures and scars on my chest and went home determined to pray and see it healed. It worked the redness went down within half an hour. all the swelling was gone by the next morning and then my fever returned to normal, so instead of six scars on my chest I have four.
Dr's are funny one time I was awake having a tunneled line put in, when the Dr said "Oh crap" I said"what ? " He replied " I just snipped an artery Ill just have to stitch it ". >:D I wonder how many mistakes they make under general anesthetic that we don't hear about
The power of prayer is amazing!
He snipped your artery? Geeze :P Ya you gotta wonder what mistakes they do make when you are NOT aware ;)
I have never had any problems with my catheter (PD) but my first one I had only 2 months healed a lot nicer than the one I had for 5 years :P
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Hi, There is a product on the market that is called ExSept Plus. (ALCAVIS INTERNATIONAL, INC.) It is a sodium hypochlorite based solution with properites that are safe, effetive and kill skin bacterial, decreasing the risk of catheter infections. It can be used on all catheter materials with any problems. We find it much better than any other antiseptics. Try it!!
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Yes, our center uses "ExCept". It works great. When they were almost done with a bottle of it, they gave it to me to have at home.
Hey, CVCclean. Welcome to the site. If you haven't already, please go to the "Introduce yourself" section and tell us a little about yourself. Thanks.
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Yes, our center uses "ExCept". It works great. When they were almost done with a bottle of it, they gave it to me to have at home.
Hey, CVCclean. Welcome to the site. If you haven't already, please go to the "Introduce yourself" section and tell us a little about yourself. Thanks.
At over $4.00 a bottle we aren't allowed to use it. It has been deemed too expensive. Instead we use Povidone at $1.52 a bottle. For those with Povidone allergies we use Hydrogen Peroxide at $.55 a bottle.
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Actually the cost of one infectious event for a dialysis patient with a central venous catheter is certainly more that the cost of 3 x weekly product use. The cost of cleaning a CVC with ExSept Plus and Alcavis 50 per treatment is pennies! If I was the patient, I would ask for the products that are the most effective, not cheapest.
Have your nurse manager contact the company. www.Alcavis.com
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Hi CVCclean, thanks for the info. Can you please go to the introduce yourself and tell us about YOU. :) Are you the patient, caregiver, nurse, tech? Looking forward to hearing more from you :2thumbsup;
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My clinic used ExSept for a short time... we had more infections with it, although the cause/effect isn't clear (were people even using it?) They took it away, not for cost reasons I was told, and got chlorhexidine instead. IMO, chlorhexidine is the best product for access site prep, both fistula/graft and CVC. Our infection rates returned to "normal". BTW, we had stopped using Betadine a long time prior to that (it's no longer recommended).
As for signs of infection: redness - maybe (culture required), drainage - most likely. Although we always did a culture, if we saw any purulent drainage the nephrologist started the patient on a broad spectrum antibx as a precaution (I never saw the culture come back negative in such a case).
Of course, chills and fever are a near certain sign of a CVC infection and require blood cultures as well.
DeLana
P.S. I haven't worked in the clinic for nearly two years and don't know what they are currently using.
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BTW, we had stopped using Betadine a long time prior to that (it's no longer recommended).
Actually betadine is what most catheter manufactures recommend to clean their catheters. It doesn't matter what the preference of the clinics or patients is it matters what the manufacturer says. There are some that it is recommended to use except or alcavis, but very few. Some of the FMC policies were just recently rewritten to incorporate RCG, and the policy about catheter cleaning has about 5 pages worth of catheter manufacturers and their recommendation on cleaning them.
EDITED: Fixed quote tag - Goofynina/Moderator
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Betadine makes me extremely itchy, so I've been using alcohol swabs... Should I inquire about using something else?
I have to go for a cathetergram on Friday. :( Been having extremely bad spasms and high arterial pressures. Whenever I used to go for a cathetergram, the doc would always try and talk me into getting another cath put in.. "Oh, it's quick! We can do it right now!" I don't want another one tho, wahhhh! < / end rant >
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Actually betadine is what most catheter manufactures recommend to clean their catheters. It doesn't matter what the preference of the clinics or patients is it matters what the manufacturer says. There are some that it is recommended to use except or alcavis, but very few.
Maybe the manufacturers need to reconsider their recommendations - the CDC has found that some bacteria grow quite well in Betadine (if used incorrectly*), this is the reason why our clinics stopped using it; chlorhexidine on the other hand kills pathogens on contact. However, I do understand that the alternatives can probably damage some catheters, so it's a real dilemma. With the intended short-term use of perm caths this would not be such a big problem, but we see a lot short term CVCs that become long term... different topic, though.
DeLana
*If workers don't soaked the cath extensions long enough or let the Betadine dry before applying the dsg (or, for that matter, let the peripheral access site dry before cannulation).
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Betadine makes me extremely itchy, so I've been using alcohol swabs... Should I inquire about using something else?
I have to go for a cathetergram on Friday. :( Been having extremely bad spasms and high arterial pressures. Whenever I used to go for a cathetergram, the doc would always try and talk me into getting another cath put in.. "Oh, it's quick! We can do it right now!" I don't want another one tho, wahhhh! < / end rant >
I had a patient whose access was a permanent Tesio - she refused to be considered for another graft (the leg would have been the only site left, she has been on dialsyis for 25 years and is doing very well*). She could not tolerate anything but alcohol swabs on her access site - and in the 5 years I worked with her, she had one catheter infection. So that's very good. You should be fine, but perhaps they have chlorhexidine, you could certainly ask.
Are you getting adequate Qb (blood flow) and clearance (Kt/V)? If so, you may be fine if you have your current Tesio revised. Anytime a new cath is placed, there is a chance of vessel damage and additional scarring, and of course no guarantee that it will work well. You could ask your surgeon about these risks (he should have already explained them to you), and perhaps get a second opinion - I do realize that's not always a realistic option.
Good luck tomorrow, let us know how it went.
DeLana
*She chooses not to pursue a transplant, and her underlying disease - an extremely aggressive glomerulonephritis that caused ESDR within a few weeks of onset of symptoms - may not make this a good choice anyway.
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Essentially there are few catheter materials on the market today: silicone and polyurethane (carbothane and tecoflex-TM) It is imperative for the handler to determine if the antiseptic/disinfectant is compatible with these catheter products. Using an incorrect solution on a hemo or peritoneal catheter can lead to catheter degredation and possibly breaking of the catheter, which can cause serious infection. Povidone iodine and chlorhexidine with alcohol are contrindicated with some catheter materials. ExSept Plus and Alcavis 50 (ALCAVIS INTERNATIONAL) are effecient and have excellent material compatibility. These products cannot become contaminated in the bottle and are cents per application. Also, it kills microorganisms in 60 seconds. It saves staff time,(2 minutes) vs. povidone iodine application. (3-5 minutes)
I am a dialysis RN with 24 years of experience in the renal field. When used per procedure, these products decrease the risk of catheter-related blood and exit site infections. Reply if you would like to know more. A team approach is what it takes to stay well! Your staff will listen.
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Essentially there are few catheter materials on the market today: silicone and polyurethane (carbothane and tecoflex-TM) It is imperative for the handler to determine if the antiseptic/disinfectant is compatible with these catheter products. Using an incorrect solution on a hemo or peritoneal catheter can lead to catheter degredation and possibly breaking of the catheter, which can cause serious infection. Povidone iodine and chlorhexidine with alcohol are contrindicated with some catheter materials. ExSept Plus and Alcavis 50 (ALCAVIS INTERNATIONAL) are effecient and have excellent material compatibility. These products cannot become contaminated in the bottle and are cents per application. Also, it kills microorganisms in 60 seconds. It saves staff time,(2 minutes) vs. povidone iodine application. (3-5 minutes)
I am a dialysis RN with 24 years of experience in the renal field. When used per procedure, these products decrease the risk of catheter-related blood and exit site infections. Reply if you would like to know more. A team approach is what it takes to stay well! Your staff will listen.
It's great to have you here at IHD CVCclean, we appreaciate your perspective. I would invite you to post in the Introduce yourself section so we can get to know you better.
Thanks
Sluff, Moderator