Double and Triple Lumen Catheter, CVL/UVC

Should be used in all large babies sick enough to require central access (exception – infants with hypoglycaemia)
- For smaller infants, individual clinical assessment is required. Reserve for those thought to require multiple infusions only.
Each lumen remains separate when enclosed together within the outer catheter i.e. the different medications do NOT mix.
The flow past the tip of the catheter is so great that incompatibility does not occur.
When one or more lumen is luered each lumen will need to be flushed every 72 hours by using the Recommended Best Practice as for single lumen central venous catheter.
The luered lumens need flushing with 1ml heparinised saline – 10 units/ml.

Administration of Drugs via a Double Lumen luered catheter

Step	Action
1	Lumen are labelled 1 and 2.
2	Antibiotics are administered over the 24 hour period via 1 lumen then the other lumen is used for the next 24 hrs. Even date give by No 2 lumen Odd date give by No 1 lumen
3	Preparation, administration, flushing of line is the same as for administration of drugs via a luered central venous catheter.
4	Double lumen catheter have a primary and secondary lumen. Each has a different volume.

Information: Sterilisation of Long line/Central Venous Catheter using antibiotics

When there is suspected line sepsis, medical staff may order antibiotics to be given through the line. Although there is conflicting information in the literature, there has been research which indicates high success in treating line sepsis with antibiotics. Vancomycin is often used for this purpose.

Points to remember:

Fluid administration through the CVL/LL will be ceased on medical order.
A pall filter with luer on the end is primed with heparinised saline 10 units per ml and attached to the long line/central venous catheter.
No dextrose solution is administered through the catheter.
The antibiotic should be diluted with saline not dextrose. In the case of Vancomycin this will be quite a large volume. The strength of saline to be used should be specified by the doctor/NS-ANP and the added sodium calculated into the baby’s total sodium intake.
It may be preferable to leave the Vancomycin in the catheter and not flush to end the procedure. Because the dead space in a Davol catheter is small, the baby will receive sufficient antibiotic and flushing at the commencement of the next dose will not cause a bolus of the drug.
If flushing is required to end the procedure, normal saline should be used before heparinised saline flush.
Heparin is incompatible with Vancomycin.

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Intravascular Catheters Double and Triple Lumen Catheters, Administration of Drugs, and Sterilisation of Longlines/CVL using antibiotics

Double and Triple Lumen Catheter, CVL/UVC

Administration of Drugs via a Double Lumen luered catheter

Information: Sterilisation of Long line/Central Venous Catheter using antibiotics

Points to remember:

Intravascular Catheters
Double and Triple Lumen Catheters, Administration of Drugs, and Sterilisation of Longlines/CVL using antibiotics