Catheter Clearance

Checking a drain that has stopped working and restoring flow

What is it?

Catheter clearance is a procedure to determine why a drainage tube has slowed or stopped and to restore flow. Live X-ray and contrast show whether the tube is clogged, kinked, or no longer in the fluid collection. The team may flush it, pass a wire through it, reposition it, or exchange it for a new catheter over the same tract.

It is used for biliary drains, nephrostomy tubes, abscess drains, and some other tubes. A blocked central line is a related problem. Sometimes that can be cleared with a medicine dwell rather than a new tube. Your team will tell you which one you are having.

Why do I need it?

A drain only helps if fluid can leave through it. Clearance may be needed when:

• Output has dropped, or the bag is no longer filling
• Fluid is leaking around the tube instead of into the bag
• You have new pain, fever, or swelling near the drain
• The tube will not flush, or it is due for a planned check and exchange

How do I prepare?

• Medicines: Tell the team about blood thinners and all other medicines. Do not stop them unless you are told to.
• Allergies: Report allergies to contrast dye, numbing medicine, latex, or adhesives.
• The tube: Do not remove the catheter. Bring the drain log if you keep one. Note when output dropped.
• Eating: You can often eat a light meal. If sedation is planned, follow the fasting instructions.
• Support: Arrange a ride home if sedation is used. Wear clothes that give access to the dressing.

How is it placed?

• You lie down so the team can reach the tube. The dressing is removed. The skin is cleaned. Numbing medicine may be used. Sedation is sometimes used.
• Contrast is injected through the catheter. Live X-ray shows if it is open, kinked, or out of position.
• A flush or a wire may clear debris. If the tube cannot be saved, the clinician passes a wire through it and places a new catheter over the wire. The old one comes out.
• The new or cleared tube is secured, connected to a bag, and dressed. A stitch or fixation device may be replaced.
• The visit often takes 30 to 60 minutes. You are watched briefly. Many people go home the same day.

Care Instructions

• Keep the dressing clean and dry. Change it as taught, or sooner if it is wet or loose. Wash your hands before touching the tube.
• Empty the bag before it is half full. Keep the bag below the level of the collection unless you were told otherwise.
• Flush only if you were taught, and only with the amount prescribed. Do not force a flush that will not go.
• Do not pull, kink, or clamp the tube unless you were told to clamp it. Avoid soaking until the team says you can.
• Record the output. A small amount of blood-tinged fluid the day of the procedure can be normal. Keep the follow-up visit.

What to watch out for

Call your care team promptly if you notice:

• Output stops again, or fluid leaks around the tube
• The tube slips out, or the cuff or stitch pulls free
• Fever, chills, or redness, swelling, or pus at the site
• New or worsening pain, or bright red bleeding that does not slow
• Trouble breathing, chest pain, fainting, or confusion — seek emergency care. If the tube falls out, cover the site and call. Do not push it back in.