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

If the VALGuard, IV tubing, or needleless cap gets dirty or wet, call your nurse whether you are at the hospital or at home. If you are home, call the home care company or the healthcare team managing your child’s central line. If this is not an option, go to the Emergency Room.  Alerting your health care team is the first step.

See additional instructions for troubleshooting issues with VALGuard below.

Important information about VALGuard:

• VALGuard 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 VALGuard in addition to a protective alcohol cap (example: DualCap®).
• The VALGuard 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 VALGuard 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. Remove the paper backing from the center of the VALGuard.
4. Use an alcohol pad to clean the outside of all tubing and connections that will be covered by the VALGuard. This includes wiping the needleless cap, central line catheter, IV tubing or protective alcohol cap (example: DualCap®).
   
   Alcohol pad
5. Clean area for 15 seconds.  
6. Allow to dry for 15 seconds. Do not blow or fan over tubing and connections after using the alcohol pad.
7. Place the connection site in the center of the VALGuard.
   
8. Place the needleless cap in the center of the VALGuard if using to cover the needleless cap when not connected to IV tubing.
   
9. Fold the VALGuard in half over the connection. Pinch the bottom edges of the VALGuard near the blue tear away strip to anchor the tubing.
   
10. Grasp the bottom of the VALGuard from the outside. Only hold the clear plastic area. Do not pinch the white paper backing.
11. Starting at one edge of the VALGuard, reach inside the VALGuard and grasp the edges of the paper backing.  
12. Remove the backing by peeling the white paper backing off slowly as you pinch the adhesive of the VALGuard together. Continue until the backing is fully removed.
    
13. Press the edges of the VALGuard together along the border to fully seal.
    

Instructions for removing VALGuard:

1. Clean your hands with soap and water or hand sanitizer.
2. Locate blue pull tab at the center of either end of VALGuard. Pull the blue tear away strip completely off the VALGuard.  
3. Gently peel VALGuard away from the line and throw in the trash.  
4. Do not use scissors to remove the VALGuard.   
5. Do not re-use a VALGuard.  
6. Clean the needleless cap with an alcohol pad (15 second clean, 15 second dry) before any central line care.

Instructions for troubleshooting issues with VALGuard:

VALGuard, IV tubing or needleless cap gets dirty or wet:

• Alerting your healthcare team is the first step. If you are in the hospital, call your nurse. If you are home, call the home care company or the healthcare team managing your child’s central line. If this is not an option, go to the Emergency Room.
• If there is a delay in receiving instructions from your healthcare team, follow these steps:
  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 VALGuard.
  3. Remove the VALGuard. Inspect the central line catheter, IV tubing, and needleless cap. If dirty or wet, wipe down with an alcohol pad (15 second clean, 15 second dry).

Threading of the needleless cap is dirty or wet while my child is at home:

• 
  If your child is followed by a home care company, immediately call the office. You will be directed on the next steps and discuss arrangements for possible dressing or needleless cap change.
• If your child does not receive care from a home care company, immediately call the health care team managing your child’s central line and/or go to your emergency room.

There are issue using VALGuard.  

• 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 VALGuard adhesive.
• Different shapes and sizes are available.

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

• Your insurance plan and home care company may require that another product be provided. Your healthcare team may provide you with samples of VALGuard . VALGuard  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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