Disconnecting the parenteral nutrition infusion for children at home: An ERNICA animation

This animation aims to provide you with some general information about how to disconnect the infusion of parenteral nutrition for children at home. The advice and techniques might vary between clinical teams. So always refer to your own care provider for the local protocol. This animation video should not replace the extensive formal training that parents should receive from expert clinicians with experience in parenteral nutrition and its administration at home. First, close the windows and turn off the air conditioning. Prepare the room and yourself. Spray any surfaces and or desk space in use. Wash your hands after removing jewelry from your hands and wrists. Tie your hair back or wear a hat. And prepare the medical set provided to you. Then prepare your child. Explain to the child that you're going to disconnect their parental nutrition. Change their nappy and empty their stoma bag if needed. Ensure that a game or distraction is available, and make sure any brothers and sisters are safe and won't interrupt. Everybody in the room should put on a surgical mask. Wash your hands thoroughly, firstly with normal soap and then again with hydro alcoholic solution for at least 30 seconds. Then, put antiseptic solution called alcoholic chlorhexidine on a sterile gauze. Ensure your child is positioned comfortably with his or her top off. The catheter hub is then disinfected using the gauze with antiseptic on it. Wipe the catheter hub with the gauze for 30 seconds. The person who is going to disconnect the catheter should then put on sterile gloves. Some clinical teams may also encourage you to wear a sterile gown. Prepare the prefilled saline syringe from your medical set. If prescribed, you should also prepare the Toroidine lock in a 1 millimeter syringe. Put a sterile sheet on the child's chest and rest the disinfected catheter hub on it. Hold the catheter hub by its fins with an antiseptic gauze. Open the valve of the catheter hub and disconnect the parenteral nutrition bag. If you are not changing the valve as well, disinfect it with an antiseptic gauze for 15 seconds. If you are going to change the catheter valve, unscrew the existing valve with an antiseptic gauze. Screw a new valve on the catheter hub. Next, inject the saline from the prefilled saline syringe into the catheter, using the pulse rinsing technique. 3 to 4 pushes on the 10 millimeter saline syringe. This is a very important procedure, to avoid the catheter being obstructed whilst it is not in use. Then remove the saline syringe. If prescribed, inject the toroidine lock slowly into the catheter, counting for 5 seconds. Then protect the catheter hub and the valve with a sterile dry gauze and a compressive elastic band. Next, protect the catheter with a band or brassiere. There is still a bit of tidying up left to do, but now the parenteral nutrition infusion is disconnected.