Patient education: How to care for an abdominal drainage catheter (The Basics)

What is an abdominal drainage catheter? — 

This is a tube used to drain fluid from the area around the organs in the belly. When fluid builds up in this space, it is called "ascites." Ascites can be caused by serious liver or heart problems, some cancers, and some infections.

An abdominal drainage catheter is a thin, flexible tube. One end is inside the belly, and the other end is outside the skin. The catheter is stitched in place where it exits the body. A clear dressing helps keep the catheter from moving around or pulling out. Most abdominal drainage catheters have a 1-way valve at the end. The valve lets air and fluid drain out and makes sure no air goes back into the belly.

An abdominal drainage catheter can stay in place for a long time.

To drain the fluid from your belly, you connect the catheter to a "drainage system." When you are not draining fluid, you cap off the catheter and coil it next to your skin.

How do I care for myself at home? — 

Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

Before you go home, your doctor or nurse will talk to you about your catheter and how to care for it. This includes how to keep the area clean to help prevent infection. You also need to check the catheter to make sure it is working correctly. Each device comes with specific instructions.

You might need a family member or friend to help you care for yourself. Some people have a home health nurse come to their home to help with this.

Your doctor or nurse will give you instructions on:

●How to care for the catheter

●How to drain the fluid into a collection system, and how often

●How much fluid to drain out – In most cases, you will drain up to 2000 mL of fluid at 1 time. Do not drain more.

How do I drain fluid from the abdominal drainage catheter? — 

Gather the supplies, and place them on a clean workspace. You need a drainage collection kit, and a small bag or trash can to throw away the old dressing and used drainage system.

Below are the general steps.

●Remove the old dressing:

•Wash your hands well with soap and water.

•To remove the old dressing, press on your skin as you slowly peel off the clear dressing. Be careful not to pull on the catheter. Gently remove any gauze covering the catheter and the foam pad under the catheter.

•Look for redness, swelling, or leaking around where the catheter enters your skin.

•Throw away the old dressing.

•Wash your hands again with soap and water.

●Connect the drainage kit to the catheter, and drain the fluid:

•Open the drainage kit. Most have a new clear dressing, gauze, foam pads, sterile gloves, alcohol wipes, a cap, and a drainage bottle with tubing. You can use the wrapper from the drainage kit as a clean work area. Put the bottle on a table near the drainage kit.

•Place the covered tip of the drainage tubing in the work area. Keep the tip sterile, and do not touch it.

•Put on the sterile gloves.

•Open the wrappers on the alcohol wipes, leaving them in their packages.

•Prepare the drainage line by closing the roller clamp. Remove the cover from the end of the line, and gently place the end of the drainage line in the work area.

•Take the cap off the catheter. Clean the end of the catheter using an alcohol wipe.

•Gently insert the end of the drainage line into the catheter. You might feel and hear a small click. Make sure the catheter and drainage line are securely connected while draining fluid.

•The drainage bottle has a seal on it. To open the seal, hold the bottle steady and remove the support clip. Gently push down on the connection between the tubing and the drainage bottle. This punctures the seal and creates the vacuum suction. The suction will make the fluid drain when you open the roller clamp.

•Adjust the flow with the roller clamp. When connected to the drainage system, the fluid in the catheter should flow freely. Draining the fluid usually takes about 15 minutes. You might feel a little discomfort or shortness of breath while draining the fluid. If so, slow or stop the flow of fluid for a few minutes.

•The flow into the bottle might slow down when the drainage is almost complete. You might feel some discomfort as the drainage slows or stops.

•When you are finished, close the clamp on the drainage line. If you need to use a second bottle, close the clamp and repeat these steps with a second bottle. Do not drain more than 2000 mL from your belly at a time.

•When the drainage is done, hold the catheter and the drainage line tip. Gently pull the drainage line tip out of the catheter.

•Clean the end of the catheter with an alcohol wipe. Twist the new cap onto the catheter until it clicks in place.

●Replace the dressing:

•Clean your skin around the catheter with an alcohol wipe. Let it air dry.

•Place the foam pad around the catheter so the end of the tube fits between the slit. Coil the catheter in loops on the foam pad, and cover with the gauze pad.

•Remove your gloves. Peel the liner off the clear dressing, and center the dressing over the top of the gauze. Press down on the dressing, but do not stretch it. Remove the paper frame slowly while pressing down to smooth the edges and seal the dressing.

●Throw away the used supplies:

•Open the roller clamp to release the remaining vacuum from the drainage bottle. Then, close the clamp.

•Empty the bottle into a toilet or sink.

•Place the used bottles in a bag. Throw away all the used supplies.

•Wash your hands with soap and water.

If the catheter pulls out, do not try to push it back in. Call your doctor right away. If you start to have trouble breathing, call for emergency help (in the US and Canada, call 9-1-1).

What else should I know? — 

You can do many of your normal activities with the catheter in place. But don't do anything that might make the catheter move out of place. Your doctor or nurse will tell you if you should avoid any specific activities.

●Do not let the catheter and bandage get wet. Do not take a bath, go swimming, or use a hot tub. Your doctor or nurse will tell you if you can shower, and how to protect the catheter from getting wet.

●Look at the catheter and bandage every day. Make sure the clear dressing over the catheter is intact. If it is loose or soiled, change the dressing.

●Don't use scissors or sharp objects around the catheter.

●Don't put anything inside the catheter except the drainage line.

●Always keep the cap on the catheter when not draining fluid.

When should I call the doctor? — 

Call your doctor or nurse if you:

●Have severe pain when draining fluid

●Have trouble breathing

●Feel weak, dizzy, or faint

●Have signs of infection, including fever of 100.4°F (38°C) or higher, or chills

●Have problems when draining fluid, such as:

●The fluid draining is bright red or very bloody.

●There are changes in the color, thickness, or amount of drainage, especially if it looks cloudy or smells bad.

●You cannot drain fluid from your belly, or there is only a small amount of drainage.

●The drainage is leaking out from where the catheter enters your skin.

●Have problems with the catheter, such as:

●Blood clots in the tubing

●The catheter leaking or cracking

●The catheter coming out – Do not try to push it back in. Call your doctor or nurse right away. You might need to get a new catheter placed.

●Swelling, redness, warmth, or pain of your skin around the catheter.

More on this topic

Patient education: Fluid in the belly from cirrhosis (ascites) (The Basics)
Patient education: Abdominal paracentesis (The Basics)