1. Hickman/Broviac Catheters Dressing Changes by Kathy Mick, R.N. and Masayo Watanabe, M.D. Section of Hematology/Oncology The Children’s Mercy Hospital

2. CHANGING THE DRESSING Your child has a Hickman/Broviac catheter. The dressing will need to be changed on a regular basis, usually weekly. This is a photo instruction manual for dressing changes in general. Ask you Nurse Specialist if you have questions.

4. GATHER SUPPLIES “Persist” dressing change tray, scissors, alcohol swabs and tape, such as “Hypafix”

6. Wash hands for 10 - 15 seconds with soap and water

7. Remove the old dressing

8. Get Kit Ready!

9. GET GLOVES ON! These gloves are sterile. Please put them on so that they stay sterile.

18. SET UP THE KIT

20. Clean the entire area to be covered by the dressing with 3 alcohol swabs Start at the catheter exit site and clean outward in a circular motion

23. Clean the Catheter Tubing with 2 Alcohol Wipes The old “Persist”, from the previous dressing change, should be removed from the catheter. Start at the exit site and clean up the catheter.

26. Clean with 3 Persist Swabs Clean the entire area that the dressing covers. Start at the catheter exit site; Clean outward in a circular motion. Let Persist air dry between swabs.

31. Let the Persist Air Dry. Then Apply the Dressing.

33. Depending upon the size of your child, you may need to cut the dressing to fit

36. Tape the Catheter down Tape should be on the skin, and not the dressing. Loop the Catheter tubing if necessary

39. Safety Precautions No contact sports or rough play No swimming or hot tubs Sponge baths are preferred If your child does want to swim, shower or bathe, place a large Tegaderm over the entire dressing

40. Call your Nurse or Doctor if: The exit site is draining, appears red or is swollen Your child has a fever > 101.3F The catheter breaks or leaks The catheter is pulled out, even partially You have difficulty to flush the catheter