# Dialysis Catheters: Protect the Connection

Catheter care and access planning are linked. Reassess the appropriate access strategy with the patient and multidisciplinary team.

![Infographic: Dialysis Catheters: Protect the Connection](https://urinenephrology.org/visual-reference/images/mastery-hd-catheter.png?v=20261003c)

## A bloodstream entry point

A dialysis catheter provides immediate access but creates infection, thrombosis, and flow risks. Each connection and dressing change is an opportunity for prevention.

## Check before use

Assess exit site, dressing integrity, tenderness, drainage, fever, and catheter function. New systemic symptoms during dialysis warrant prompt evaluation.

## Keep the hub protected

Use trained hand hygiene, mask, aseptic connection, hub disinfection, and dressing technique. Keep disinfected hubs away from nonsterile surfaces and use a new sterile cap as directed. Lock solution and volume must match the catheter and protocol; do not improvise because a lumen is difficult to aspirate.

## Treat bloodstream infection as more than a dressing problem

Fever or rigors during dialysis needs prompt assessment, cultures through the approved pathway, and timely antimicrobial treatment. Persistent bacteremia, tunnel infection, instability, or metastatic infection changes catheter-management urgency. Coordinate source control and future access rather than repeatedly treating cultures without addressing the catheter.

## Document and communicate

Record site findings, flow problems, symptoms, and interventions. Repeated poor function or recurrent infection needs review beyond a single treatment.

## Keep a longer-term plan

Catheter care and access planning are linked. Reassess the appropriate access strategy with the patient and multidisciplinary team.

## Source lessons

- [catheter care crbsi](https://urinenephrology.org/mastery/maintenance-hd/catheter-care-crbsi.html)

Read alongside the full lessons; the findings and decisions shown here require the stated clinical context.