All right.
So, now we're going to change the dressing and you're going do that every
7 days, unless it gets wets.
Whenever it gets wet,
you always want to change it immediately that's very, very important
sometimes you'll have a patient say, " I didn't want to call you.I didn't want
bother you,"
and all of the complications and things that can go wrong
can usually be quickly remedied if they'll only call us
Ok so, make sure you do a really good job of cleaning your hands
before you do anything. And then for this, you have addressing kit.
This is sterile, so what's inside of here is very, very clean, and we want to keep it that
way
we want to take it out only as we use it
and make sure that it
stays sterile. So for this part we are gonna put on
gloves. They're not sterile gloves, but they're extra protection.
What about a mask? Sometimes nurses wear masks. Good point.
If you had a cold or something, we would want you to wear a mask. Oh, OK
Anybody helping take care of you that has many symptoms of an infection--
a cold and respiratory infection--should wear a mask.
You're going to be my assistant now, so you
will lift your shirt. I'm going to take the dressing off.
I want to get the edges loosened.
If I just do that very gently, these nice Tegaderm dressings will come right off.
You want to be careful to make sure that you do get the edges
loosened first. As you see, you have some tape
underneath here. Just pull that down. There.
And we've loosened it up.
You're good to go. I have to do this in a mirror
Mirror is actually a very good point.
It's a great thing to have a mirror there, and if you can't do it in
front of a mirror,
the other good thing is to have a mirror that you can use to inspect, because
this point when we've
removed the dressing-- and you wouldn't have a shirt on at home, probably doing this...
So, when you're doing it by yourself, if you have a mirror, you want to look all around to be
sure that there's no signs of infection, no redness
I'm going to change the gloves, becuase we just removed the dirty dressing.
So,
the first thing I'm going to do is clean the area around your catheter. You're going
to squeeze these wings together until you hear the little click.
And then you're going to hold the
sponge this way, and the liquid is in this little tube,
and that's going to come and fill up the sponge so that you can clean the area.
You really want to scrub with this. This is really the best protection you
can do, and it needs to be
30 seconds. The second most important thing is that now that you've done the
30 seconds, you have to let it dry.
You have to let it dry for a minimum of 30 seconds.
When I was in the hospital, I had this white....almost like a patch.
So, we don't use that. Ok so, inBill sometimes they do use those.
They're called a Bio patch, and it has the same
solution in it that we just scrubbed your area with
called ChloraPrep. That's on there in inBill--you don't need to apply
apply that, but you do
want to take it off. You would take off and discard it and
then just put your dressing on. Good enough. All right, so the last part is putting the protection
on, which
is the dressing.
So, these dressings are designed so that you can put them on sterilely,
and it's a very light, nice dressing, but it comes with
lots of backing on it to protect it and stop it from
sticking to itself. It has these tabs, and those are the tabs you want to pull
when you do this. You want to put the dressing
right on, so that I never touch any of the area
that
is on your skin. SO, you can see that we have made this
nice, sterile dressing. Then the last piece comes on.
So, the purpose of the tape is to make sure
that the line doesn't get pulled. You don't want to hook
onto something
and get pulled, so this is a protection We're going to slide that
right up onto there, and
we're going to make a little notch on it and slide
it up under the tube.
And that all comes right with the package? It comes right in the kit.
OK
We're going to put that over that. And what that does is if you were to pull on this,
it's going to pull on the tape and not the dressing.
When you put the tape on, make sure you don't put it all on the dressing.
You want it mostly on your skin,
just on the the very edge of the dressing. That provides
the ability to stop it from pulling
Now, you said every 7 days? Every 7 days
Ok. I would say that it's a
temporary inconvenience for a long-term solution.
I'm the primary caregiver. I do all of the flushing
of the Hickman. I keep track of the medications that he needs to take.
And between us, I guess we manage the schedule. We have a regular calender
schedule that I write things down
on every day to keep us on track