These instructions are for Children’s Hospital of Philadelphia (CHOP) patients who are recommended to use AquaGuard^® to prevent the catheter and dressing from getting dirty or wet.

Important information about Aquaguard:

• 
  AquaGuard is a moisture barrier that is used to protect a central line catheter and dressing from possible infection. It can prevent stool, saliva, vomit, urine, or feeding tube drainage from getting on the central line needleless cap and central line dressing.
• Some children are at a higher risk of getting their central line dirty or wet. Wearing a diaper, having loose stools, frequent vomiting, respiratory secretions, ostomies, and feeding tubes (G-tubes and J-tubes) may increase this risk.
• If you will use an AquaGuard at home, the healthcare team will show you how to use this product. Practice applying this product before discharge so you know what to do at home.

Instructions for applying AquaGuard to protect the central line dressing from stool and bodily fluids:

1. Choose an appropriate AquaGuard size. It needs to be large enough to prevent the adhesive from touching your child’s central line dressing.  
2. Trim the adhesive backing off at least one edge of the AquaGuard before applying it.  This will allow the dressing site to be open to air and not trap moisture. Do not use scissors near the central line.
   
3. Remove the paper backing from one edge of the AquaGuard at a time. It is helpful to fold a small tab on each paper backing strip so that the backing can be easily removed while applying each side.
   
4. Firmly apply one side at a time. Apply the first AquaGuard edge closest to the source of potential soiling (for example, closest to the diaper or child’s mouth).
   
5. Firmly apply all remaining sides. The adhesive should not touch your child’s central line.
   
   
   
6. If needed, pinch together excess material to form a pleat.
   
7. Fold the pleat to the side to seal the material. If the AquaGuard does not cover the catheter(s), secure the catheter(s) away from the area at risk for soiling. For help, partner with your child’s nurse.
   
8. Change the AquaGuard with each central line dressing change or earlier if dirty, wet, or adhesive edges are not intact. 

Instructions for removing AquaGuard:

1. Gently peel the AquaGuard down in the same direction as your child’s hair growth.
   
2. Start at the top left or top right corner. Do not disturb the central line dressing or catheter.
3. Do not use scissors to remove the AquaGuard.  
4. Do not re-use an AquaGuard.

Instructions for troubleshooting issues with AquaGuard:

AquaGuard is sticking to the central line dressing or the dressing begins to peel up while removing the AquaGuard:

• Do not try to remove the AquaGuard further.
• Call the healthcare team:
  • If you are in the hospital, call your nurse.
  • If your child is followed by a home infusion agency, immediately call the office.  
  • If your child does not receive care from a home infusion agency, immediately call the healthcare team managing your child’s central line and/or go to the emergency room.  

Central line dressing, needless cap or IV tubing gets dirty or wet:

• Call the healthcare team for direction on next steps and arrangements for possible dressing or needleless cap change.
  • If you are in the hospital, call your nurse. The nurse will perform necessary central line care (such as dressing change, needleless cap change, IV tubing change) after wiping down the central line and any IV tubing with an alcohol wipe.
  • If you are at home, and your child is followed by a home infusion agency, immediately call the office.  
  • If you are at home and your child does not receive care from a home infusion agency, immediately call the healthcare team managing your child’s central line and/or go to the emergency room.
• Use a clean cloth to wipe away any moisture or body fluid that got on the IV tubing, catheter, or central line dressing.   
• Use an alcohol wipe to wipe down all tubing.  

Your child’s skin is red, irritated or there is an issue with using AquaGuard.  

• Talk with the healthcare team managing your child’s central line before stopping the use of this product. Stopping use without talking to your team about other options may increase your child’s risk of central line soiling and line complications.  
• Other products can be used if your child is sensitive to the AquaGuard adhesive.
• Different shapes and sizes are available.

You did not receive enough supply of AquaGuard or a different product was delivered.

• Your insurance plan and home infusion agency may require that another product be provided. Your healthcare team may provide you with samples of AquaGuard. AquaGuard is also available for retail purchase. 

Call the CHOP team managing your child’s central line with any questions or concerns.

If you have any questions about your child’s health, please contact your child’s healthcare provider. This document is intended only to provide general educational information and is not intended as medical advice or treatment. Please consult with your healthcare provider prior to use, as some of this information may need to be adapted for your child’s specific needs. It is the responsibility of your healthcare provider to advise you on the appropriate use of this information. If you/your child are not already a CHOP patient, this document does not create a doctor-patient relationship between you/your child and CHOP. CHOP is not responsible for any outcomes you/your child might experience from your use of this document. This document is provided "AS IS", WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, express or implied. If this document refers to any drugs or medical devices, it is the responsibility of your healthcare provider to check the FDA status prior to use. If this document includes references to drug dosing, please do not rely on this document. Your healthcare provider should check the package insert for each drug before use. Hyperlinks used within this document may not be translated into other languages.

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