Non-tunneled Central Lines

What is a non-tunneled central line?

A non-tunneled central line is a type of IV catheter. A catheter is a flexible tube used to give treatments and to take blood. A non-tunneled central line is placed into a large vein near your neck, chest, or groin.

Why do I need a non-tunneled central line?

Non-tunneled central lines are used to give you medicines and treatments. They are often put in if you have to give IV medicines to yourself at home. Caregivers may not be able to use smaller veins in your body. In an emergency, a non-tunneled central line gives easy access to your bloodstream, and medicine may work faster.

How can I prevent catheter-associated infections?

The area around your catheter may get infected, or you may get an infection in your bloodstream. A catheter-associated infection is caused by bacteria (germs) getting into your bloodstream through your catheter. Infections from catheters can lead to severe illness. The following are ways you can help prevent an infection:

  • Wash your hands: Use soap or an alcohol-based hand rub to clean your hands. Clean your hands before and after you touch the catheter or the catheter site. Ask your caregiver for information on how to wash your hands. Remind anyone who cares for your catheter to wash their hands.

  • Wear medical gloves: Wear clean medical gloves when you touch your catheter or change bandages.

  • Limit contact: Do not touch or handle your catheter unless you need to care for it. Do not pull, push on, or move the catheter when you clean your skin or change the bandage.

  • Clean your skin: Clean the skin around your catheter every day and just before you change your bandage. Ask your caregiver what to use to clean your skin.

  • Check for infection: Check your skin every day for signs of infection, such as pain, redness, swelling, and oozing. Contact your caregiver if you see these signs.

  • Cover the area: Keep a sterile bandage over the catheter site. Change the bandage as directed or when it is loose, wet, dirty, or falls off. Change your bandage in a place away from open windows, heating ducts, and fans. Be sure it is well-lit, clean, and free of dust. Clean the skin under the bandage with the solution your caregiver suggests. Let the area dry before you put on the new bandage.

  • Keep the area dry: Do not let your catheter or catheter site get wet. Cover the catheter site with plastic and seal with medical tape before you bathe.

How should I care for my non-tunneled central line?

Your caregiver may want you to do the following to reduce your risk of infection or complications:

  • Clean the catheter parts: Clean the caps, hubs, and injection ports before you attach and after you remove tubing from your catheter. Open the package that contains the new alcohol pad. Put on new medical gloves. Use a new alcohol pad for each part you clean. Throw away used alcohol pads.

  • Flush your catheter: Your caregiver may give you syringes filled with saline (salt water) or heparin (a blood thinner) to flush your catheter.

    • Attach the syringe that contains the flushing solution to the end of the catheter tubing. Slowly push the fluid out of the syringe and into the catheter. Throw the syringe away. Clean the end of the catheter or cap with a new alcohol pad.

    • Do not force the fluid. Force could damage the catheter, or release a blood clot from the end of the catheter. Straighten any kinks in the tubing. Contact your caregiver if it is still hard to push fluid into the catheter.

  • Change the caps and medicine tubing: You may need to use extra tubing to get medicine. Ask your caregiver how often to change the caps and the medicine tubing.

  • Clamp the catheter: You may need to clamp your catheter at certain times, such as when the caps and tubing are being changed. The catheter is clamped to help prevent air from getting in.

  • Loop extra tubing: Loosely loop the tubing together. Secure it to your arm with medical tape. This will help prevent the catheter from being pulled out by accident.

What are the risks of having a non-tunneled central line?

  • The catheter may go into the wrong area or blood vessel during the procedure. Air or blood may get into the space around your lungs, causing heart or lung problems. You may get an infection where the catheter enters your body, or in your bloodstream. The catheter may break, bend, or move out of place, and not work. You may need to have the catheter removed, and a new one placed.

  • Medicine may leak on your skin, causing swelling, pain and blisters. You can have bleeding, an allergy to heparin, or heparin-induced thrombocytopenia (HIT). HIT is a low number of blood platelets, which increases the risk of bleeding. You may get a blood clot in the vein where your catheter was placed. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot may break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.

  • If you do not have a central line placed, you may not be able to get the medicines or treatments that you need. If medicine that harms small veins is given through a regular IV, your veins may be damaged.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.

  • The catheter site is red, warm, painful, or oozing fluid.

  • You see blood on your bandage and the amount is increasing.

  • The veins in your neck or chest bulge.

  • You cannot flush your catheter, or you feel pain when you flush your catheter.

  • You see that the catheter is getting shorter, or it falls out.

  • You see a hole or a crack in your catheter. Clamp the catheter above the damage before you contact your caregiver.

  • You have questions about how to care for your catheter.

  • You run out of supplies to care for your skin or catheter.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have pain in your arm, neck, shoulder, or chest.

  • The catheter site turns cold, changes color, or you cannot feel it.

  • You see blisters on your skin around where the catheter enters it.

  • You have chest pain or trouble breathing that is getting worse over time.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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