Discharge Instructions: Caring for Your Apheresis Catheter

A catheter is a thin, flexible tube. An apheresis catheter is put into a vein in your chest. The internal tip of the tube sits in a vein near your heart. The end of the catheter from your chest has 2 or more short tubes with caps called ports. This catheter is in place so your healthcare team can take stem cells from your blood. They may give you medicines and fluids through the tube. And they may take some blood for testing.

At home, you need to take good care of your catheter. A catheter has a high risk of infection. You must take extra care to protect it from germs. This sheet will help you care for the catheter at home.

Understanding your role

A healthcare provider will teach you and other caregivers how to take care of the catheter. Make sure you understand:

• What to do at home

• How long you may need the catheter

• When to have a follow-up visit

Fill in the information below.

Your follow-up visit date: _____________________________________

Catheter dressing change due date: _____________________________________

Healthcare provider in charge of your catheter: (name/phone number) ____________________

Who to call with concerns about your catheter: (name/phone number) ____________________

Protecting the catheter

If the catheter gets damaged, it won’t work. It could lead to an infection. Call your healthcare team right away if it gets damaged. To protect the catheter at home:

• Prevent infection. Wash your hands well (see below). Don’t touch the catheter or dressing unless you need to. Clean your hands well before and after you touch any part of the catheter. Make sure your caregivers, family members, and visitors wash their hands.

• Keep the dressing and catheter dry. The catheter and dressing must stay dry. Don’t take a bath, swim, use a hot tub, or do other things that could get them wet. Ask your provider the best way to keep them dry if you shower. Or take a sponge bath. If the dressing gets dirty, loose, or wet, change it only if you have been shown how to do it with sterile gloves. If not, call your healthcare team right away for help.

• Don’t damage the catheter. Don’t use any sharp or pointy objects near the catheter. This includes scissors, pins, knives, razors, or anything that could cut it or put a hole in it. Don’t let clothing pull or rub on the catheter.

• Watch for problems. Keep track of how much of the catheter sticks out from your skin. If this changes, call your healthcare provider. Watch for cracks, leaks, or other damage. Watch for signs of infection. These can include pain that gets worse, swelling, redness, bleeding, or fluid from the area.

• Don't lower your chest below your waist. When your chest is below your waist, the internal tip of the catheter could slip out of place in the vein. Don’t bend down to put on your shoes. Sit down to put on your shoes. Use a reacher or ask for help to pick things up off the floor.

• Call your healthcare team if you vomit or have severe coughing. These can make the internal tip of the catheter slip out of place.

Watching for a blood clot

A blood clot can block blood flow in the vein where the catheter is placed. Symptoms of a blood clot include pain or swelling in your neck, face, chest, or arm. If you have any of these, call your healthcare provider right away. You may need an ultrasound exam to find the blood clot. You may need to take a blood thinner medicine.

Cleaning your hands

A catheter can let germs into your body. This can lead to a serious infection. To prevent this, make sure that you, your caregivers, visitors, and roommates keep their hands clean. Never touch the catheter or dressing before you clean your hands. Wash your hands well with soap and water, or clean them with alcohol-based hand gel. Ask your healthcare team when it’s OK to use hand gel, or when you need to wash with soap and water.

To wash hands well with soap and water:

1. Wet your hands with clean, running water. Don't use hot water. It can irritate skin when you wash your hands often.

2. Apply enough soap to fully cover your hands and fingers.

3. Rub your hands together briskly for at least 20 seconds. Rub the front and back of each hand up to the wrist. Rub your fingers and fingernails, between the fingers, and each thumb.

4. Rinse your hands with clean, running water.

5. Dry your hands fully with a new, unused paper towel. Don’t use a cloth towel. Don’t use any reusable towel. These can have germs.

6. Use the paper towel to turn off the faucet. Throw the paper towel away. If you’re in a bathroom, use a paper towel to touch the doorknob.

If you don’t have access to soap and water:

• Use alcohol-based hand gel to clean your hands.

• Make sure the gel has at least 60% alcohol.

• Wet your hands and fingers fully with gel. Rub them together well.

• Let the alcohol gel dry fully.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

• Signs of infection at the catheter site, such as pain that gets worse, swelling, redness, bleeding, or fluid

• Fever of 100.4° F (38.0°C) or higher, or as directed by your provider

• Chills

• Pain or swelling in your neck, face, chest, or arm

• The length of catheter from your chest has changed

• Cracks, leaks, or other damage to the catheter

• Wet, loose, dirty, or damaged dressing

• Coughing, wheezing, or shortness of breath

• A fast or irregular heartbeat