Peripherally Inserted Central Catheters And Midline Catheters Child

WHAT YOU SHOULD KNOW:

  • A catheter is a small tube used to give treatments and to take blood. The catheter is guided into place through a peripheral vein in your child's upper arm. Peripheral veins lead from your child's arms and legs to his heart. A peripherally inserted central catheter (PICC) is guided into a vein near the heart. A midline catheter is guided into a vein below the armpit.

INSTRUCTIONS:

Prevent catheter-based infections:

The area around your child's catheter may get infected, or he may get an infection in his bloodstream. A catheter-associated infection is caused by bacteria (germs) getting into your child's bloodstream through his 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 area where it is inserted. Ask your child's primary healthcare provider (PHP) for information on how to wash your hands. Remind anyone who cares for your child's catheter to wash their hands.

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

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

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

  • Check for infection: Check your child's skin every day for signs of infection, such as redness, swelling, and oozing. Ask your child if he has pain in the area his catheter was placed. Contact your child's PHP 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 child's 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 child's PHP suggests. Let the area dry before you put on the new bandage.

  • Keep the area dry: Do not let your child's catheter or catheter site get wet. Wrap your child's arm with plastic and seal with medical tape before he bathes. Ask if your child should take showers instead of baths.

Care for your child's PICC or midline catheter:

  • Clean the catheter parts: Clean the caps, hubs, and injection ports before you attach and after you remove tubing from your child's 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 child's catheter: Your child's PHP may give you syringes filled with saline (salt water) or heparin to flush your child's catheter. Heparin is a medicine that helps prevent blood clots from forming inside the catheter. Heparin can cause an allergic reaction or bleeding problems.

    • 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 away the syringe. 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 child's PHP if it is still hard to push fluid into the catheter.

  • Change the caps and medicine tubing: Your child may need extra tubing to get medicine. Ask your child's PHP how often to change the caps and the medicine tubing.

  • Clamp the catheter: You may need to clamp your child's catheter at certain times, such as when the tubing is 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 child's arm with medical tape. This will help prevent the catheter from being pulled out by accident.

Follow up with your child's healthcare provider as directed:

Write down your questions so you remember to ask them during your child's visits.

Warm compresses:

The area where the catheter was inserted may feel sore. A warm compress can help to decrease pain and swelling in your child's arm. Wet a small towel with warm water. Wring out the extra water. Wrap the cloth in plastic, and put it on the area. Use the compress 4 times a day, for 10 minutes each time. Prop your child's arm on pillows when he is sitting or lying down to decrease swelling.

Do not give aspirin to children under 18 years of age:

Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.

Contact your child's primary healthcare provider if:

  • Your child has a fever.

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

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

  • The veins in your child's neck or chest bulge.

  • You cannot flush your child's catheter, or your child feel pain when you flush his catheter.

  • You see that the catheter is getting shorter, or it falls out. Put pressure over the site with a clean towel.

  • You see a hole or a crack in your child's catheter. Clamp the catheter above the damage before you contact your child's primary healthcare provider.

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

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

Return to the emergency department if:

  • Your child has pain in his arm, neck, shoulder, or chest.

  • The body part where the catheter is placed turns cold, changes color, or your child tells you that he cannot feel it.

  • Your child has chest pain or trouble breathing that is getting worse.

© 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.

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.

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