My Drainage Catheter

No one wants a drainage catheter, but now that you’ve got one, there are a few things that you should know.  This guide provides information so that YOU can participate in ongoing care of your drainage catheter.  By participating in the care of your drainage catheter, you will shorten the length of time that you’ll need it, and be able to have it removed sooner.  

Your drainage catheter was placed so that internal fluid could be continuously drained from within your body.  The fluid may be infected or sometimes it is not infected but needs to drain for a while.  There is a suction bulb that pulls fluid through the drain, this fluid collected in the bulb, measured, and then discarded.  Drainage should be continuous – that is, the drain and the bulb should be working so that all available fluid can be removed at any time.

What to expect from your drainage catheter.

There is no “right” color or consistency of the fluid.  If the fluid is not infected, it is usually clear and often golden in color.  Infected fluid ranges from cloudy to opaque, and may be thin or thick and creamy, yellow, green, brown, or gray.  As fluid drains, it is hoped that the amount that is collected each day will decrease.  It is important to record the daily “output” from your drain so that the amount of fluid that drains can be tracked over time.  It’s possible that as the amount of fluid diminishes, there may be no drainage at all.  When there is no drainage, there are two possibilities – the fluid may be completely gone, or the drainage system may be incapable of removing fluid (clogged tube or no suction).

Provided that there is little fluid left to drain, the drainage catheter is usually removed when the output drops to less than 25-30ml per day and or when the fluid in no longer considered to be infected.

Caring for your drain:

Caring for your drain is easy.  If there isn’t much drainage, you can empty the bulb once each day.  Otherwise you may need to empty it 2 or three times per day, recording the amount each time.

Squeeze the bulb flat and connect to drain tubing plug so that the suction works again.

Keep the drain site clean with soap and water, or peroxide.  Keep a clean, dry gauze dressing over the drainage catheter entry site into the body.  If the dressing becomes wet, change it for a dry one.

Flushing the drain:

You may be instructed to flush the drain, particularly if the fluid is thick. This will keep the drain from becoming clogged (with re-accumulation of fluid in the body and a delay in ultimate removal of the drain). Learning to flush the drain takes some simple training, but once you understand the procedure it is easy and takes 5 minutes.  You must take a small syringe (5 or 10ml) and fill it with sterile water or saline.  There should be a 3-way stopcock in the line between the drain and the bulb.  

If you’ve done it right, the bulb will suck the fluid from the drain, and you will see the fluid in the tube that leads to the bulb.

How to empty the drain

  1. Wash your hands well with soap and water.
  2. Pull the plug out of the bulb.
  3. Pour the fluid inside the bulb into a measuring cup.  Measure how much fluid you collected.  Write the amount of your drainage and the date and time you collected it on a drainage chart. Flush the fluid down the toilet.
  1. Clean the plug with alcohol.  Then squeeze the bulb flat.  While the bulb is flat, put the plug back into the bulb.  
  1. The bulb should stay flat after it is plugged so that the vacuum suction can restart.  If you can’t squeeze the bulb flat and plug it at the same time, use a hard flat surface (such as a table) to help you press the bulb flat while you replug it.
  2. Wash your hands.

How to care for the skin and the drain site

  1. Wash your hands well with soap and water.
  2. Remove the dressing from around the drain.  Use soap and water or saline or peroxide on a gauze pad/cotton pad.  Clean this area once a day.
  3. When the drain site is clean and dry, put a new dressing around the drain.  Put surgical tape on the dressing to hold it down against your skin.
  4. Place the old dressing into the trash.  If it is bloody, wrap it in a small plastic bag.
  5. Wash your hands.

Complications

Sometimes, a large amount of fluid may leak from around the drain site, making the gauze dressing completely wet.  If this happens, first flush the drain to be sure it isn’t clogged.  Then, remove the dressing and use soap and water or peroxide to clean the area.  Verify that the bulb drain is secured and “flat” to provide the needed suction.

Another potential problem is the development of a clot within the drain.  This appears as a dark, stringy plug.  It could prevent the drainage from flowing through the tube.  You can “milk” this clot along the tube by “stripping” it – pinching the tube and sliding your pinched fingers toward the bulb or you can flush it into the bulb using 5-10cc flush and turning the stopcock so that the fluid is pushed into the bulb.

As your internal fluid collection drains, the cavity where the fluid formed gradually collapses.  Sometimes a small amount of blood enters the fluid as this happens.  Do not worry if there is a small amount of blood as long as the drain is free from clot.  However, if there is obvious bleeding that fills the bulb, contact your interventional radiologist at (650) 404-8445 daytime, or go to the emergency room if there is a lot of bleeding or sudden pain.