San Antonio, TX: Klein Baker Medical, 1998, with permission.)

Table 32.4 Examination of the Catheter Site

Assessment Comments

Catheter:

Note external catheter length

Catheter length should be clearly documented. If external length has changed, get radiograph(s) to assess where the

catheter tip is located.

If the catheter is pulled out, cover site with occlusive dressing and measure catheter length to assure that some of the

catheter was not retained in the vessel.

Assess for kinks, tension, damage Kinks and tension can damage catheter. It is recommended that damaged catheters be removed, but some manufacturers provide repair kits.

Insertion site/surrounding skin:

Erythema, drainage, bleeding, edema,

phlebitis, skin breakdown

Mild erythema and/or phlebitis is common after the catheter is inserted. If condition is severe and/or is persistent,

consider removing catheter.

Mild oozing of blood should not persist longer than 24 h.

Edema may be due to venous stasis from lack of extremity movement, constrictive dressings, thrombus, damage to

internal structures, localized infection, or infiltration of infusion into soft tissue.

Avoid skin breakdown by utilizing skin barriers underneath hub, removing dressing adhesives with care, minimizing

tape, and removing antiseptics from skin before applying dressing.

Drainage/leaking Purulent drainage may be due an infectious process. Consider obtaining blood cultures and/or removing the catheter.

Clear drainage may be indicative of infusion leakage. This may be due to catheter occlusion, infiltration, or damage

to catheter.