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2nd June 2025

For all CVAD Competent staff

Please read carefully for a couple of updates in relation to CVAD care and Disconnection of chemotherapy Infusers.

Royal Derby Hospital (RDH) has informed us, due to some issues with the Baxter infuser pump, used for chemotherapy, they have on occasions needed to connect the infuser directly to the end of the CVAD line, no needle free device in situ whilst the infusion goes through. For community nurses then removing the infuser and giving the CVAD line a flush.

  • For this procedure please wear the correct PPE, including Nitraguard chemotherapy gloves. Ensure Cytotoxic, purple lidded sharps bin is available with no top applied.
  • Identify patient/introductions given and gain informed consent. Wash hands and using a clean surface, open dressing pack and arrange equipment. Apply sterile apron and chemotherapy gloves.
  1. Using sterile gauze, prime new needle free device with Posi flush ensuring air removed before attaching. Leave Posi-flush attached to the Needle free device.
  2. Apply clamp and put Infuser bottle into the cytotoxic bin.
  3. Using sterile gauze, disconnect infuser from end of the CVAD line, using cap from end of one of the posi flushes, attach to the end of the infuser bottle line and put into cytotoxic bin.
  4. Clean end of hub for 30 seconds, air dry for 30 seconds. Then attach new primed needle free device and flush with two 10mls posi flush, using the push-pause technique finishing on positive pressure when applying clamp. DO NOT withdraw prior to this as do not want to withdraw chemotherapy.
  5. If a heparin lock has been prescribed, please flush this with 10ml syringe finishing on positive pressure, when applying clamp. If no clamp insitu on the line, hold the end of the syringe as removing to maintain positive pressure.
  6. Apply Curos cap.
  7. Secure line with comfifast.
  8. Remove PPE, put into bin bag from dressing pack and put into Purple lidded cytotoxic bin. Secure top to bin and close and write date etc on the bin. Bin is returned to the acute hospital by the patient.

RDH have also asked us to cascade that when securing the CVAD, please DO NOT apply gauze around the end and definitely DO NOT apply micropore tape around the end of the line to secure gauze, this has caused incidents on removing the tape on the following line care.