Patient observed sterile treatment for intravenous catheters
| POST for intravenous catheters: When you stay in a hospital, a doctor may propose to insert a catheter into a vein. This is a needle with a tube attached and is also called a scalp vein set. After sticking the needle into a vein, the provider tapes the tube to your arm, where it can stay for several days.[i] The tube ends in a port (closed by a plug or valve) through which a provider can inject medicine into your vein. |
| 1. Avoid skin-piercing procedures |
If a doctor proposes to stick a catheter into a vein in your arm or anywhere else, ask if he or she could give you medicines through injections and/or orally instead. |
| 2. Use new disposable instruments |
(a) A disposable catheter does not cost much. Ask your provider to take a new disposable catheter from a sealed plastic bag opened in front of you.(b) When the provider gives you medicine through the catheter, he/she uses a syringe to inject it into the catheter tube. Ask the provider to use a new disposable syringe or to reuse the same one for you only (see Injection section).
(c) Make sure the medicine the provider injects into the catheter comes from a single-dose vial, or a multi-dose vial set aside for you only (see Injection section).
(d) If you have a catheter, the provider will inject saline through the catheter from time to time, so the catheter does not get clogged. Make sure the saline comes from a bottle for you only. You can buy a bottle to keep by your bed. |
| 3. You sterilize the instruments |
This is not relevant. Avoid, or use disposables. |
| 4. Ask providers how they sterilize instruments |
This is not relevant. Avoid, or use disposables. |
Additional information on intravenous catheters
Contaminated syringes, multi-dose vials, and saline bottles: Intravenous catheters have all the risks that you get with infusions, plus additional risks. A lot of doctors and nurses think the port at the end of a catheter is sterile, which is not at all so. Thinking it is safe, many doctors and nurses reuse the same syringe to put medicine into catheters for one patient after another, drawing more medicine from time to time from multi-dose vials. Thus, with catheters you have to worry not only about the needle and tube, but also about all the syringes and multi-dose vials that are used to put medicine through the catheter.
Scalp vein set
Because catheters can get clogged when they are not used, nurses will often inject saline solution to keep them open; the syringe to do this may be reused, and the saline often comes from a bottle used for many patients (like a multi-dose vial).
Because of all these risks, you are generally safer taking injections from time-to-time rather than having a catheter. Whether or not you will have a catheter is something you might have to work out with your doctor. So be ready to discuss.
Risks with intravenous catheters
If your provider takes a catheter (needle and tube) from an HIV-positive patient, and then with no effort to clean reuses it on you, your risk to get HIV from the catheter may be estimated at 10% (see Table on Estimated risks in Blood-borne risks section). But even if you get a new catheter, you are at risk for HIV if your provider reuses syringes to inject medicines and saline into one catheter after another, and takes medicine and saline from multi-dose vials.
If the catheter is new, if the provider uses new syringes for you, and if the provider takes medicines and saline from new vials and bottles set aside for you, you have no risk to get HIV from the catheter.
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