Going home with your Tunneled Catheter

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Going home with your Tunneled Catheter Your Tunneled Catheter was put in by on Interventional Radiologist Date Your Tunneled Catheter was put in at: McMaster University Medical Centre Hamilton General Hospital Juravinski Hospital and Cancer Centre If you have any problems with your Tunneled Catheter, call your community or primary nurse. Brand name of Tunneled Catheter Non-valved (open ended) or Valved Size or gauge of the Tunneled Catheter Length of external catheter (exit site to hub) cm. Number of lumens Single Double Triple Stitches to be removed: Date Comments: The above information was completed by Nurse/Technologist on, Area Phone Date:

2 Going home with your Tunneled Catheter You are going home with a tunneled catheter. The catheter is a long thin tube and may stay in your chest for several months or years. Your tunneled catheter may be used: to give fluids to give medications for nutrition to give blood products to take blood samples Keep all dressings clean and dry. Your tunneled catheter will need routine care, such as dressing changes and flushing. Your nurse will discuss this with you. Home care When you go home right after having your tunneled catheter placed, the Interventional Radiologist will arrange for home care through the Community Care Access Centre (CCAC). A CCAC nurse will contact you to arrange an appointment for follow-up care with a nurse. If you have not heard from the nurse within 24 hours, call the CCAC at 1-800-810-0000. Sedation If you received sedation, you must not do the following for the next 24 hours: drive any type of car, bike or other vehicle operate machinery or power tools drink alcohol and/or take mind altering substance make important decisions or sign a legal document What do I do once I get home? Rest for the remainder of the day. Do not do strenuous activity or heavy lifting for the next 1 to 2 days. When you return to your normal routine, do not overuse your arm or shoulder on the side with the tunneled catheter. Take your usual medications when you get home except blood thinners (anticoagulants). Check with the doctor who inserted you tunneled catheter or your family doctor or specialist before starting your blood thinners.

Going home with your Tunneled Catheter 3 When you first get your tunneled catheter When you first get your tunneled catheter, it is normal for the area around your tunneled catheter to be sore. You may have stitches on your chest and neck. The soreness may last a few days. It may bleed or ooze a little. Your CCAC nurse will check and change the dressing. Please let the nurse know your concerns. You may take Tylenol as needed, or your regular pain medication as ordered by your doctor. If the pain gets worse or does not go away, call your family doctor or specialist. If you cannot reach them, go to an Emergency or Urgent Care Centre. clamp When the stitches have been removed, your catheter will be healed enough to hold itself in place under the skin. From then on, the dressing covering the catheter needs to be changed weekly.

4 Going home with your Tunneled Catheter When you have a tunneled catheter, DO NOT: use scissors near the tunneled catheter swim with the tunneled catheter pull or tug on the catheter use pins near the catheter get the dressings wet if the dressing gets wet it will need to be changed Safety Your CCAC nurse will discuss safety tips for your tunneled catheter. Always keep your tunneled catheter covered with a dressing. Make sure that the dressing stays on and does not get wet. Secure the catheter so that your clothes do not pull on it. When you return to your normal routine such as household chores, cooking, work, sexual activity, you can move as you feel comfortable. Do not overuse your arm or shoulder on the side with the tunneled catheter. Your tunneled catheter needs special care to keep it clean and working well. This care may be done by you, a family member, a friend or a nurse. Your CCAC nurse will help you learn about the care of your tunneled catheter.

Going home with your Tunneled Catheter 5 When you get home watch for these problems: Problem The dressing is soaked with blood. The dressing is soaked with clear fluid. The area around your tunneled catheter gets more puffy and swollen. The tunneled catheter breaks. The cap falls off the end of the catheter. Swelling of neck, arm or face on the side that the catheter is located. What to do Do not remove the dressing. Apply pressure with another dressing or clean towel. Call your CCAC nurse. If you bleed a lot or the bleeding does not stop go to the Emergency Department. Cover with a clean dressing or clean towel. Call your CCAC nurse or specialist right away. If you cannot reach them, go to an Urgent Care Centre or Emergency Department. Pinch and fold over the catheter above the break. Use your safety clamp to clamp above the broken area, closest to your body. Cover the broken end of the catheter with gauze or clean towel and tape. Go to the Emergency Department. Make sure catheter is clamped. Clean the end of catheter with an alcohol swab and apply a new end cap, or cover the open end of the catheter with gauze and tape or new cap. Call the doctor who arranged your catheter placement. If you cannot reach them, go to the Emergency Department right away. Go to the Emergency Department right away. If you have trouble breathing, irregular or strange heart beat call 911 or go to the Emergency Department. If you are unsure of what to do or have concerns about your tunneled catheter, call your CCAC nurse.

6 Going home with your Tunneled Catheter Supplies There are 2 options for tunneled catheter care and supplies provided by CCAC (Community Care Access Centre): CCAC will make an appointment for you to attend a Nursing Care Centre for tunneled catheter care CCAC will have supplies delivered to your home and home care will be provided. Keep your supply box in a clean, dry and safe place. Keep it away from children and pets. Supplies needed if you have home care: liquid soap, in a pump or bottle or waterless soap paper towels garbage bag clean towel sharps container (if using needles) When you have a tunneled catheter, it is a good idea to: keep your emergency telephone numbers close by have your CCAC nurse or hospital telephone number close by keep a list of your questions, problems, notes in a book or diary keep a calendar for clinic appointments When doing your tunneled catheter care: set aside 20 to 45 minutes limit distractions, such as not answering your phone clean your work area before and after tunneled catheter care

Going home with your Tunneled Catheter 7 Setting up your home You will need a work area or space to lay out the supplies. When choosing the best place to do your tunneled catheter care, keep these things in mind: good lighting a room that is easy to keep clean and free of dust a comfortable spot in the room to sit or lie down a safe area away from children and pets a place free of drafts away from open windows, heating ducts and fans clean surface for supplies Your CCAC nurse will help you to learn as much as you can about your tunneled catheter so that you will be able to become as independent as possible. If you want to learn more about changing your dressing or other parts of your care, please ask your CCAC nurse. Call your CCAC nurse if you have problems with your tunneled catheter or supplies: Your CCAC nurse s name: Phone number: please turn over

8 Going home with your Tunneled Catheter Notes: Hamilton Health Sciences, 2005 PD 4738-07/2015 dpc/pted/tunneledcathgoinghome-trh.doc dt/july 23, 2015