Interventional procedures for neonates

• The date of catheter insertion must be recorded in the follow-up records.
• No topical antibiotics (ointments or creams) should be applied to the umbilical catheter site to prevent fungal infections or antibiotic resistance.
• A daily examination must be conducted to check for signs of infection, inflammation, bleeding, or circulatory insufficiency, such as skin discoloration in the lower limbs.
• The catheter must be removed immediately in the following cases:
• If it is no longer needed.
• Arterial catheters should be removed before the fifth day.
• Venous catheters should be removed by the fourteenth day, as the risk increases with prolonged use.
• The catheter must not be replaced immediately after removal due to signs of catheter-related bloodstream infection, circulatory insufficiency in the lower limbs, or blood clotting. However, an umbilical venous catheter may be replaced only if it is not functioning efficiently and no infection is present.
• The catheter must never be left open to prevent air embolism risks.
• A continuous infusion of a heparin-containing solution (0.25 units/mL) must be maintained when using an umbilical arterial catheter. This infusion should never be stopped during its use.
• If inflammation appears at the catheter insertion site, a sample should be taken for culture.
• A blood culture should be performed both from the catheter and a peripheral vein if catheter-related infection is suspected. If the catheter is removed, a culture should be taken from the catheter tip.

Responsible Personnel:

• Nursing staff.