Patient Instructions: Aquaguard to Protect Central Line Catheter Caps and IV Connections

Patient Instructions: Aquaguard to Protect Central Line Catheter Caps and IV Connections

These instructions are for Children’s Hospital of Philadelphia (CHOP) patients who are recommended to use AquaGuard® to protect central line needleless cap or central line IV connections from getting dirty or wet.

Important information about Aquaguard:

  • AquaGuard®
    AquaGuard is a moisture barrier. It can prevent stool, saliva, vomit, urine, or feeding tube drainage from getting on the central line needleless cap and central line connections.
  • 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.  
  • Children who are at a higher risk of getting their central line dirty or wet will still benefit from using AquaGuard in addition to a protective alcohol cap (example: DualCap®).
  • The AquaGuard should be changed when dirty or wet, when removing IV tubing, and when accessing the central line.  
  • 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 needleless cap and connections:

  1. Clean your hands with soap and water or hand sanitizer.
  2. Check that the needleless cap and all tubing connections are not loose.  
  3. Peel off 3 of the 4 paper backing strips. Two strips are short. Two strips are long. Leave one of the longer strips in place.
  4. Fold one corner of the AquaGuard over itself. Use the side opposite the remaining white paper strip. The fold helps with removing the AquaGuard when needed.
  5. Use an alcohol pad to clean the outside of all tubing and connections that will be covered by the AquaGuard. This includes wiping the needleless cap, central line catheter, IV tubing or protective alcohol cap (example: DualCap).

    Alcohol pad
  6. Clean area for 15 seconds.  
  7. Allow to dry for 15 seconds. Do not blow or fan over the tubing and connections after using alcohol pad.
  8. Place the connection site in the center of the  AquaGuard.
  9. Place the needleless cap in the center of the AquaGuard if using to cover the needleless cap when not connected to IV tubing.
  10. Fold the AquaGuard in half over the connection. Leave about a third of the outer border of the white paper strip uncovered. This allows for easy removal.


  11. Run your fingers over the outside edge of the AquaGuard. This seals the adhesive together.  Do this over the tubing.

Instructions for removing AquaGuard:

  1. Clean your hands with soap and water or hand sanitizer.
  2. Remove the AquaGuard where the white paper backing strip is still in place. Discard in the trash.  
  3. Do not use scissors to remove the AquaGuard.  
  4. Do not re-use an AquaGuard.  
  5. Clean the needleless cap with an alcohol wipe (15 second clean, 15 second dry) before any central line care.

Instructions for troubleshooting issues with AquaGuard:

AquaGuard gets dirty or wet:

  • If you are in the hospital, call your nurse. The central line needleless cap may need to be changed.   
  • If you are home:
    1. Clean your hands with soap and water or hand sanitizer.
    2. Use a clean cloth to wipe down all tubing and the outside of the  AquaGuard.
    3. Remove the AquaGuard. Inspect the central line catheter, IV tubing, and needleless cap to be sure connections and needleless cap are not dirty or wet.  
    4. Reapply a new AquaGuard following the steps above.   

Tubing connections or threading of needleless cap is dirty or wet while my child is at home:   

  1. Use a clean cloth to wipe away any moisture or body fluid that got on the IV tubing, catheter, or needleless cap.
  2. Use an alcohol pad to wipe down all tubing and the outside of any connections or needleless cap. Clean for 15 seconds. Allow to dry for 15 seconds. Do not blow or fan over the connections or cap.
  3. If your child is followed by a home infusion company, immediately call the office. You will be directed on the next steps and discuss arrangements for possible tubing or needleless cap change.
  4. If your child does not receive care from a home infusion company, immediately call the healthcare team managing your child’s central line or go to the emergency room.

There are issues using AquaGuard.

  • Threading points
    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.
  • 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 company 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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