How to Change a Dressing for a Hemodialysis Catheter

Indications for Dialysis Catheter Dressing Change
📌 A dressing change at home is necessary if it becomes loose or starts falling off, appears or feels wet, or is soiled or bloody.
🚫 Avoid performing dressing line care in the bathroom due to potential higher germ presence compared to other rooms.
📋 Gather necessary items including a dressing change kit, sterile and clean procedure gloves, CHG Tegaderm dressing, hand sanitizer, and a sharpie.

Procedure Steps: Preparation and Initial Removal
😷 Masks must be worn by everyone completing or observing the procedure; the child must wear a mask or turn their head away from the site.
👐 Perform hand hygiene, put on a mask, and then don clean procedure gloves.
🤏 To remove the old dressing, support the skin and catheter while grasping one edge and gently pulling straight out to stretch and release it from the skin across all four corners.
👁️ After removal, inspect the skin for signs of infection like redness, drainage, or swelling, then discard gloves and the old dressing.

Sterile Dressing Application
🧼 Perform hand hygiene again and don sterile gloves, ensuring minimal contamination by only touching the outer edges of the package and glove cuffs.
💧 Place sterile contents onto the sterile wrapper, pick up the ChloraPrep applicator, and squeeze the wings to release the solution.
🌀 Apply the sponge to the exit site, scrubbing back and forth over the catheter for 30 seconds (or two minutes if lines are near the armpit or groin).
🛡️ Apply No Sting Barrier Film where the outer edges of the dressing will lay, then place the sterile dressing leaving 1 to 1.5 inches surrounding the site.
✍️ Secure the site by placing V-notched tape under the tubing over the dressing edge, removing the paper backing, and applying No Sting Barrier Film around the outer edge for added security; write the date on the new dressing.

Aqua Guard Use and Emergency Preparedness
🚿 An Aqua Guard (plastic cover) protects the dressing from getting wet during showering or bathing; apply it firmly over the entire dressing.
💧 The Aqua Guard only protects against splashing water; it should not get soaking wet and must be discarded after each use, requiring a fresh one for every shower/bath.
🚨 Keep an emergency supply bag accessible, containing two pairs of hemostats, Tegaderms, and 4x4 gauze pads, whether at home or traveling.
🆘 If the tube clamp falls off and there is active bleeding, immediately clamp the tube with a hemostat and call 911. If the cap falls off without active bleeding, clamp the tube and go to the nearest ER.

Key Points & Insights
➡️ The primary reasons for an urgent dressing change are if it becomes loose, wet, or soiled/bloody.
➡️ Scrubbing the exit site with ChloraPrep requires 30 seconds, extending to two minutes if the lines are close to sensitive areas like the armpit or groin.
➡️ In a catheter emergency involving active bleeding after the catheter falls out, apply a folded 4x4 gauze over the site, secure it with a Tegaderm, hold pressure, and call 911.

📸 Video summarized with SummaryTube.com on Feb 02, 2026, 23:46 UTC