Prior to using the new needleless connector, cleaning the Luer lock threads of the female catheter connector is now very important. All nurses have been instructed to wrap the alcohol pad around the catheter connector and rotate it several times before allowing it to dry. After four days, it is time for you to replace the pinless connector, it will not come off at all. Try as much as possible, it won't budge. Your only idea is to have a hemostat clamp the catheter sleeve, or another hemostat to secure the needleless connector and twist it. But even that won't work! Why does this happen and what do you do?
First, what is the evidence for such cleaning on a catheter hub? Many hospitals have also adopted this wheel cleaning practice. Dry blood, drug deposits, and skin grease can easily contaminate the catheter connector, and these fragments can easily enter the catheter lumen.
Due to the type of plastic used in those devices, the needleless connector can be permanently welded to the catheter connector. Thermoplastic polyurethane is a common material type for these devices, but there can be many different types in this group. Strength and durability are great features, but some types cannot tolerate alcohol. Ethanol (the type used for drinking and intravenous infusions) and isopropanol (common disinfectants) can soften plastics. Sometimes even drying the alcohol thoroughly is not enough, but this may be the problem. The softened surface of the catheter hub may be permanently secured by a used needleless connector. There may be no way to remove the pinless connector.
Please note that the use of hemostatic agents can easily cause ruptures and leaks in the catheter connector. This can provide any entry for the organism to enter the lumen. Unremovable needleless connectors or broken catheter hubs may require new catheters to be inserted.
Before developing this cleaning policy, please check the instructions for use (all booklets in the box with the central venous catheter) for detailed information on the use of ethanol on all parts of the catheter, including the hub. Some people have specific statements about cleaning the wheels with alcohol. Others have warned of the use of alcohol for skin disinfection and the instillation of alcohol to clear obstructions in the lumen of the catheter, but there may be no word on the application of alcohol to the catheter connector.
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