Tunneled Central Lines Adult

WHAT YOU SHOULD KNOW:

• A tunneled central line is also called a catheter (kath-uh-ter). A catheter is a small flexible plastic tube. The catheter is put in through and then tunneled under your skin a short distance. Your doctor may put the catheter into a vein near your neck. It then enters a large vein by your heart. A vein is a tube inside you that carries blood from your body to your heart. The other end of the catheter usually exits the skin on your chest below the collarbone.
  
  
• You may have 1 to 3 small tails (tubes) hanging out from where the catheter was put in. These tails may have caps and clamps on them. With a central line, you may have blood taken for tests, and get IV fluids. Having a central line may keep you from being stuck with a needle many times.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• There are always risks with any medical procedure. You may have more bleeding than usual or get an infection (in-fek-shun). You could have trouble breathing, or get blood clots. Your caregivers will watch you closely for these problems. Sometimes the tip or end of the catheter will move out of place, or become damaged or blocked. If this happens, you may need to have a new catheter put in.
  
  
• If IV fluid leaks out of the vein into your body, you could get an infection. This may also damage the skin around the catheter. Air could get into your blood through the catheter, or you could get an irregular heartbeat. Rarely, your lung may collapse, or the catheter could break apart inside you and you may die. Call your caregiver if you are worried or have questions about your medicine or care.

GETTING READY:

The Night Before the Procedure:

• Ask your caregiver if you need to stop taking aspirin or any other blood thinning medicines before your procedure.
  
  
• You may need blood tests before your procedure. Talk to your caregiver about these or other tests you may need. Write down the date, time and location for each test.
  
  
• You may be given a pill to take to help you sleep.
  
  
• Ask caregivers about directions for eating and drinking.

The Day of the Procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• Ask your caregiver before taking any medicine on the day of the procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
  
• If you are staying in the hospital after the procedure, bring your personal belongings with you. These include your bathrobe, toothbrush, denture cup (if needed), hairbrush, and slippers. Do not wear jewelry or bring money to the hospital.
  
  
• Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• If you go home right after the procedure, someone should drive you. Do not drive yourself home.

TREATMENT:

• You will be asked to change into a hospital gown. You may be given medicine to help you relax or make you drowsy. You will be taken to a different room for the procedure. You may get medicine to numb the area where the catheter will be inserted. Your central line will be put into a vein near your neck.
  
  
• Your bed may be tilted so that your head is lower than your feet. This makes blood fill up the veins in your neck and chest, making the veins easier to find. You may need hair clipped in the area where your catheter will go. Your caregiver will clean the area with soap and water. This soap may make your skin yellow, but it will be cleaned off later. Towels will be put over you to keep the area clean. Do not touch the towels or the area after it has been cleaned.
  
  
• Fluoroscopy, a type of x-ray, may be used to put in the catheter so doctors can see that it goes into the right place. Your doctor will make a small incision (cut) through your skin. The catheter will be tunneled under your skin, then put into your vein. Tell your caregivers if you have trouble breathing, tingling, numbness or pain in your chest, ear or arm. Your doctor can move the catheter to make this stop.
  
  
• An x-ray may be taken to make sure the catheter is in the right place. Your doctor may use stitches (thread) to sew the catheter to your skin so it won’t move. Bandages will be put on the incision. If it was lowered, the head of your bed will be raised.

Waiting Room: This is a room where your family can wait until you are ready for visitors after surgery. Your doctor or nurse can then find them to let them know how the procedure went. If your family leaves the hospital, ask them to leave a phone number where they can be reached. When it is time for you to go home after your procedure, someone will need to drive you home. Do not drive home alone. An adult should stay with you for at least 24 hours after surgery.

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• You have questions or concerns about having your catheter put in.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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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