APPENDIX B.

Summary of Recommended Frequency of Replacements for Catheters, Dressings, Administration Sets, and Fluids

CatheterReplacement and Relocation of DeviceReplacement of Catheter Site DressingReplacement of Administration SetsHang Time for Parenteral Fluids
Peripheral venous cathetersIn adults, replace catheter and rotate site no more frequently than every 72–96 h. Replace catheters inserted under emergency basis and insert a new catheter at a different site within 48 h. In pediatric patients, do not replace peripheral catheters unless clinically indicated.Replace dressing when the catheter is removed or replaced or when the dressing becomes damp, loosened, or soiled. Replace dressings more frequently in diaphoretic patients. In patients who have large bulky dressings that prevent palpation or direct visualization of the catheter insertion site, remove the dressing and visually inspect the catheter at least daily and apply a new dressing.Replace IV tubing, including add-on devices, no more frequently than at 72-h intervals unless clinically indicated. Replace tubing used to administer blood, blood products, or lipid emulsions within 24 h of initiating the infusion. No recommendation for replacement of tubing used for intermittent infusions. Consider short extension tubing connected to the catheter to be a portion of the device. Replace such extension tubing when the catheter is changed.No recommendation for the hang time of IV fluids, including non-lipid-containing parenteral nutrition fluids. Complete infusion of lipid-containing parenteral nutrition fluids (eg, 3-in-1 solutions) within 24 h of hanging the fluid. Complete infusion of lipid emulsions alone within 12 h of hanging the fluid. Complete infusions of blood products within 4 h of hanging the product.
Midline cathetersNo recommendation for the frequency of the catheter replacementAs above.As above.As above.
Peripheral arterial cathetersIn adults, do not replace catheters routinely to prevent catheter-related infection. In pediatric patients, no recommendation for the frequency of catheter replacement. Replace disposable or reusable transducers at 96-hour intervals. Replace continuous flush device at the time the transducer is replaced.Replace dressing when the catheter is replaced; when the dressing becomes damp, loosened, or soiled; or when inspection of the site is necessary.Replace the IV tubing at the time the transducer is replaced (ie, 96-h intervals).Replace the flush solution at the time the transducer is replaced (ie, 96-h intervals).
CVCs including peripherally inserted central catheters and hemodialysis catheters* Do not routinely replace catheters.Replace gauze dressings every 2 d and transparent dressings every 7 d on short-term catheters. Replace the dressing when the catheter is replaced; when the dressing becomes damp, loosened, or soiled; or when inspection of the site is necessary.Replace IV tubing and add-on devices no more frequently than at 72-h intervals. Replace tubing used to administer blood products or lipid emulsions within 24 h of initiating the infusion.No recommendation for the hang time of IV fluids, including non-lipid-containing parenteral nutrition fluids. Complete infusions of lipid-containing fluids within 24 h of hanging the fluid.
Pulmonary artery cathetersDo not replace catheter to prevent catheter-related infection.As above.As above.As above.
Umbilical cathetersDo not routinely replace catheters.Not applicable.Replace IV tubing and add-on devices no more frequently than at 72-h intervals. Replace tubing used to administer blood products or lipid emulsions within 24 h of initiating the infusion.No recommendations for the hang time of IV fluids, including non-lipid-containing parenteral nutrition fluids. Complete infusion of lipid-containing fluids within 24 h of hanging the fluid.
  • * Includes nontunneled catheters, tunneled catheters, and totally implanted devices.