About this topic
A central line catheter is a very long intravenous line (I.V.). The Broviac, Hickman, Hohn, and PICC are different kinds of central lines. They are long, thin, flexible tubes or catheters. The catheter is put in your arm, neck, groin, or chest through the skin. It goes into a large blood vessel that leads to your heart. It gives a direct path into your blood. Germs can easily get in your blood from your central line. It is important to take extra care to try and keep this from happening. ‚
This kind of I.V. is used if you need to have drugs or fluids for a few weeks or months. Based on how much drug or nutrition you need during treatment, the catheter may have 1, 2, or 3 tips. These let you get fluid, drugs, or liquid food. A central line is also used when drugs need to be given through an I.V. and the veins in your arm are very hard to find. A central line may be used to give drugs that are irritating to small veins. This kind of I.V. can also be used to draw blood for tests or to monitor your condition. ‚
With a central line catheter, you will not need to have as many needlesticks. These catheters can stay in place for weeks or months. Some people may have a central line catheter for years. ‚
General
Changing the Central Line Dressing ‚
Keeping the skin clean and changing the dressing as ordered may help to prevent infection. How often you need to change the dressing will depend on a few things. You will always change the dressing at least one time each week. If the dressing is wet, loose, or dirty, change it right away. You or someone in your family can learn how to do this. Others have a nurse come in to help with this care. ‚
- Gather supplies and place them on a clean work space. You will need sterile gloves, chlorhexidine swab sticks, tape, and sterile dressings.
- Always wash hands well with soap and water before touching the catheter line. This will help to avoid spreading germs. Wear a mask when changing the dressing. Also, have the patient wear a mask or keep the head turned away while the dressing is being changed.
- Take off the old dressing. Avoid using scissors or sharp tools. They could cut the catheter. Do not pull on the central line catheter when taking off the dressing.
- Check the site for swelling, drainage, or redness.
- Wash hands again. Put on sterile gloves.
- Wash with a chlorhexidine swab using a circular motion for 30 seconds. Start at the exit site, wash the catheter, and wash away from the site. Let the cleaned area air dry for at least 30 seconds.
- Some doctors will order a small disc that will help prevent infection. Put the disc around the catheter where it comes out of the skin. The colored side should be facing away from the skin.
- Lay the catheter on the skin in a loose circle if it is long, or in a straight line if it is short. It should not lay on top of where the catheter goes into the skin or lay on itself. Put the dressings snugly on all sides of the catheter. Most dressings are clear and will stick to the skin. If it is not sticking, put medical tape on the edges to hold it in place.
- Throw away the old dressing and used swabs and wipes.
- Wash your hands with soap and water.
Flushing the Catheter ‚
The catheter line should be flushed each day with a sterile fluid. It should also be flushed after each use. This will help keep the line from getting blocked. ‚
- Gather supplies and place them on a clean work space. You will need rubbing alcohol with cotton balls or wipes. You will also need a 10 mL syringe filled with the fluid to flush the catheter. Your doctor may order heparin or normal saline for you to use. You may need more supplies if you have more than one opening to flush.
- Your doctor may have you use a smaller amount of fluid to flush the line if the catheter is in a child.
- Wash your hands with soap and water.
- Scrub the cap for at least 15 seconds with a rubbing alcohol wipe on the top and sides and let dry.
- Remove the end cap from the syringe and check for air bubbles. Slowly push the syringe plunger forward until all the air is out of the syringe.
- Screw the syringe onto the end of the cap that covers your catheter line.
- Unclamp the catheter and inject the flush into the catheter. Flush slowly and steadily until the syringe is empty.
- Remove the syringe from the catheter. Throw away into a container designed for used syringes. This is called a biohazard container. Do not throw away syringes in the trash.
- If the catheter has many tips, called lumens, repeat for each lumen.
- Use new supplies for each lumen. Do not reuse the same syringe.
- Throw out any used swabs, wipes, or materials.
- Wash your hands with soap and water.
Changing the Injection Cap ‚
- Gather supplies and place them on a clean workspace. You will need sterile injection cap, one for each catheter tip or lumen.
- Wash your hands with soap and water.
- Remove the new injection cap from the package without touching the ends.
- Clamp the catheter line and remove the old cap.
- Scrub the end of the catheter for at least 15 seconds with alcohol and let air dry.
- Remove the sterile tip protector from the new cap.
- Screw the new cap onto the catheter connector.
- Throw out any used swabs, wipes, or materials.
- Wash your hands with soap and water.
Special Precautions ‚
- Avoid contact sports or rough play.
- Keep sharp objects away from the catheter.
- Avoid swimming in ponds, lakes, rivers, ocean, or hot tubs.
- Keep the dressing covered when bathing. Change the dressing if it gets wet, dirty, or becomes loose.
- Help keep the catheter in place by wearing clothing that fits snugly against the body.
- Keep the catheter clamped when it is exposed to air. For example, when connecting an I.V. or when the cap is being changed. Your doctor will teach you when and how to clamp your catheter the right way.
- Make sure to check the line every day for signs of infection.
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What problems could happen?
- Infection
- Bleeding from the skin or end of the catheter
- Blood clots in your vein or at the end of the catheter that can cause a blockage
- Break or crack in the catheter
- Leakage of drugs outside the vein, under the skin or fat tissues
- Air in the blood or air embolism
- Abnormal heartbeat
When do I need to call the doctor?
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills.
- Redness, yellowish drainage, warmth, stinging, or pain at the catheter site
- Catheter falls out all the way or part of the way
- Breaks, cracks, or leaks in the catheter
- Not able to get the drugs or flush solution through the catheter
- Not able to get a blood return from your catheter
- You have any concerns about your catheter
- You are not feeling better in 2 to 3 days or you are feeling worse
Teach Back: Helping You Understand
The Teach Back Method helps you understand the information we are giving you. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these: ‚
- I can tell you about my condition.
- I can tell you how I will change my central line dressing.
- I can tell you what I will do if I have redness or drainage from the catheter site.
Where can I learn more?
National Institute of Health ‚
http://www.cc.nih.gov/ccc/patient_education/pepubs/hickman.pdf ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
Copyright
Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚