USING THE FAS ENDOLUMINAL BRUSH TO OBTAIN A BIOFILM
SAMPLE FROM A CENTRAL VENOUS CATHETER WHILE THE
CATHETER IS IN-SITU
Note: This protocol is for illustrative purposes.
Each Hospital Unit should review and agree criteria for implementing the use of the FAS Endoluminal Brush and adjust these protocols according to the unit’s agreed standards.
INTENDED USE:
Microbial evaluation of catheter lumens:
A. To evaluate the need for routine catheter exchange (to be done 24 hours
prior to scheduled or normal hospital exchange protocol)
B. In cases of suspected sepsis of unknown origin
C. In routine surveillance
RECOMMENDED PROTOCOL:
N.B. Please read the Instructions for use that is provided with the FAS Endoluminal Brush kit prior to implementing brushing. This protocol summarises the key steps of the procedure.
1. Determine which FAS Endoluminal Brush is appropriate for the lumen to be sampled.
2. Place the patient in the supine position and create a sterile field around the hub of the catheter.
3. Wearing gloves and gown, and practising aseptic technique, withdraw fluid from the lumen to be sampled to ensure it is free of drugs, then flush the lumen with 20mls sterile physiological saline solution.
4. Clamp the line, disconnect flushing syringe and swab the catheter hub.
5. Open the Brush pack and measure the Brush against the known length of the lumen to be brushed and create a definitive kink in the Brush wire at the precise measurement. (Note: when the kink locates against the sheath collar, the Brush will be 1.5cms from the tip of the catheter).
N.B. Do not remove the Brush from its protective sheath.
6. Connect the FAS Endoluminal Brush to the catheter.
7. Advance the Brush into the hub and release and line clamp.
8. Continue to advance the Brush into the catheter lumen in short but even steps until the kink locates against the sheath collar.
9. Withdraw the Brush in a single smooth movement beyond the line clamp.
10. Close the line clamp and disconnect the brush from the hub.
11. Put the end of the Brush into the sterile vial and, using sterile wire clippers or sterile scissors, cut the wire 5cms from the end. Seal the vial.
12. Connect a sterile 5ml syringe to the catheter, release the line clamp and withdraw 5mls of blood.
13. Flush the catheter with 20mls of sterile physiological saline.
14. Recommence treatment.
15. Label vial and send to Microbiology. Document in patient notes.
