Ventricular Assist Device – Gauze Dressing Change

Transcript

Ventricular Assist Device – Gauze Dressing Change The ventricular assist device (VAD) driveline dressing remains in place for the first 48 hours. It will be reinforced with extra dressings as needed. After 48 hours a gauze dressing will be applied and changed every day for the first 5 to 7 days. If you still have drainage after this time, you will continue to use a gauze dressing. As healing occurs and there is less bleeding and drainage, you will switch to a window dressing. A separate handout is provided about caring for a window dressing. Preventing infection is very important when you have a VAD. Look at the site carefully each time your remove the dressing. Watch for signs of infection. Call your doctor right away if you have any of these signs of infection:  Fever at or above 100.5° F (38°C).  Redness, swelling or warmth at the site.  Red streaks anywhere near the site.  Drainage that is yellow, green or smells bad.  Increased pain. Ways to Prevent Infection  Keep your hands clean.  Do not let anyone touch the site without first washing their hands and wearing gloves.  Handle the driveline gently. Do not let it move around too much.  Clean the skin and driveline with each dressing change. When to Change Your Dressing  At least once a day.  After every shower.  Any time the dressing becomes damp, loose or soiled. To Prepare for the Dressing Change  Clean a table with a household disinfectant.  Place these supplies on the clean table: □ Alcohol based hand sanitizer or soap and water □ Gauze Driveline Management Kit Steps to Follow Every Time 1. Wash your hands. 2. Open your kit and unroll the first fold. 3. Put on your mask. Have the patient put on a mask. 4. Put on clean, wrapped gloves. 5. Use the alcohol swabs to weaken the adhesive and remove the old dressing. 6. Throw the old dressing away and remove your gloves. 7. Wash your hands. 8. Put on the sterile, wrapped gloves. 9. Pick up the ChloraPrep swab and gently clean a wide area around the driveline.  Spend 30 seconds gently scrubbing all 4 sides moving from the driveline outward.  Allow to dry for 2 minutes. 10. Repeat cleaning this area in the same way for 30 seconds with a second ChloraPrep swab.  Allow to dry for 2 minutes. 11. Take one split-gauze and place it under the driveline. 12. Put five 4 inch by 4 inch gauze sponges on top of the split gauze. 13. Apply skin prep to areas where the adhesive dressing will touch the skin.  Allow to dry for 2 minutes. 14. Center the adhesive dressing over the edges of the gauze and firmly smooth all edges. 15. Use the small closure device to close the dressing over the site. Push it up and under. 16. Place the driveline anchor device below the small closure adhesive and under the line. Press down to ensure it sticks to the skin. 17. Find the arrow on the base of the driveline anchor device. Pull the tab on the other side from the arrow to make an opening in the slit. Push the tab next to the arrow into this opening. 18. Holding onto both tabs, pull them in opposite directions until the first tab pulls through the slit, locking into place. Tell your nurse or doctor if you have any questions or concerns about the VAD dressing. Dev. 11/14 © Mount Carmel 2014