Collaborative Intravenous Nursing Service (CINS) Guidelines

SYSTEMIC INFECTION71Signs & Symptoms• Fever and chills without other apparent reason• Malaise• Nausea and vomiting• Low grade pyrexia• Unresponsive to broad spectrum antibiotics• Headache• May be no evidence of sepsis at catheter site• Raised WBC and Raised CRP• May be discharge from exit siteActions• Monitor site dailyContinue to use strict asepsis and always use needlefreesystem• Take cultures from VAD and independent venoussample• Treat with IV antibiotics or combination of oral and IVsas indicated by Medical MicrobiologistResolvedUnresolvedPROCEED WITH CAUTION AS LONG ASTHERE ARE NO OTHERCOMPLICATIONS OR PAIN• Seek advice from IV specialist nurse or referring keyworkerphysician and Medical Microbiology• Assess need for VAD and patient's immune system• Swab catheter site, any wound, sputum and urine• Line lock to salvage line if clinically well. Consult specialist nurse orseek medical help.The CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10