How we Prepare Charlie's TPN at Home
TPN is normally given through a large central vein.
For Charlie A catheter was inserted into the vein in his chest seen in the images above, under local anesthesia and sterile conditions. Charlie’s sits on the left of his chest just below the nipple. The placement is done in an operating room to decrease the chance of infection. Several different types catheters are used based on the reason TPN is needed and the expected length of treatment. CVL Catheters are made of silicone. Once the catheter is in place, a chest x ray is done to make sure the placement is correct.
For Charlie his home TPN prescription is made weekly under sterile conditions. Maintaining sterility is essential for preventing infection. For this reason, the outside tubing leading from the bag of solution to the catheter is changed daily, and special dressings covering the catheter are changed every other day.
CHARLIE'S TREATMENT ROOM
This is our spare room where we store Charlie's bags of TPN and ancillaries along with setting up Charlie's TPN. All of this should be in a sterile environment.
I then move on to opening all of the items and place them in the above tray, ensuing i do not touch any of the ends.
In the tray you can see three sterile wipes to clean the end of charlies CVL before connecting the follwing, you can also see an empty syringe to draw back 2.5ml Turalock, pre-filled syringe of sodium chloride to flush the line,
The main giving set and spiral extension set, parafilm for sealing the connections.
TPN & PUMP
Charlie's TPN and Pump are then setup and put either in his rucksack or on to his drip stand.
Everything is now ready to take through to Charlie. We connect him either on our bed or on the sofa depending on the situation and time of day.
First i wash my hands with surgical scrub and alcohol gell. Then i glove up and start to clean both of the blue trays you can see in the previous image on top of the fridge. Both are cleaned with sterile wipes. 1st i start with opening a wound care pack and place all items i need on top of the sterile paper towel.
How we set up Charlie's TPN
All Set up
Away he goes!!