Tunneled Central Lines Child

WHAT YOU SHOULD KNOW:

• A tunneled central line is a type of catheter. A catheter is a small flexible plastic tube. The catheter is tunneled a short distance under your child's skin before it enters a large vein. Your child's doctor may put the catheter into a vein near your child's shoulder or neck. A vein is a blood vessel that moves blood through your child's body.
  
  
• Where the catheter comes out of the skin, there may be up to three small tails (tubes) hanging out. These tails have caps and clamps on them. With a central line, your child may have blood taken for tests and get IV medicines. Having a central line may keep your child from being stuck with a needle many times.

AFTER YOU LEAVE:

Medicines:

• Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.
  
  
• Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.
  
  
• 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.
  
  
• Saline: A solution called saline may need to be flushed through the central line. Saline is a special mixture of salt and water. This liquid may help keep the catheter open and clear.
  
  
• Heparin: A solution called heparin may need to be flushed through the central line. Heparin is medicine that helps prevent blood clots from forming inside the catheter. If heparin is used to flush the catheter, problems including allergic reaction, bleeding, and heparin-induced thrombocytopenia (HIT) could develop. HIT is a low number of blood platelets, which increases the risk of bleeding.
  
  
• Home IV medicines: Ask caregivers for information about the medicines and treatments that your child needs. Medicines may be brought to your home. Read the labels on the medicine. Ask caregivers if the medicine needs to be stored in the refrigerator. Follow caregivers directions for giving the medicine through your child's catheter.
  
  
• Using a medicine pump: A pump may be used to give medicine through the central line. You may be taught to prepare and attach the medicine to the pump. Caregivers will teach you how to use the pump. Ask caregivers what to do when the alarm sounds, and how to take care of the pump.

Ask for more information about where and when to take your child for follow-up visits:

For continuing care, treatments, or home services for your child, ask for information.

Hand washing:

Always wash your hands with soap and water before touching the central line or the area around it. Hand washing helps prevent infection. Ask caregivers for information about hand hygiene. Do not touch or handle the catheter unless you need to give your child medicine or a treatment, or to care for the central line. Teach your child to avoid touching or handling the catheter. Wash your hands and put on new medical gloves before touching or handling the catheter.

Catheter care:

The place where the catheter is inserted must be checked daily for signs of infection and other problems. Your child's skin must be cleaned before every bandage change. The bandage over the area and the caps on the catheter lumens must be changed. The tubing used to give medicine or liquids must also be changed. Ask your caregiver how often these tasks need to be done, and who will do them. If you need to do any of these tasks, ask caregivers for written directions.

Flushing the central line:

The central line may need to be flushed. This is when you push a small amount of fluid through the central line using a syringe. This liquid may be saline (sterile salt water), heparin (blood thinning medicine), or both. Flushing is done to help prevent the catheter from getting blocked. Flushing is also done to help prevent medicines from mixing with each other in the tubing. Ask caregivers what to use if you need to flush the central line, and ask them to show you how to flush it correctly.

Catheter blockage:

If your child's catheter is blocked, it may be hard to push in the plunger (the inside part of the syringe). Do not force the plunger. Call your caregiver right away. Follow caregiver's instructions closely for flushing your child's catheter so it doesn't get blocked.

Activity guidelines:

Do not let your child go swimming. Swimming exposes the central line to germs that can cause infection. It is better to take a shower than a bath when there is a central line in place. Your child should not use the arm with the catheter to lift or push things. Teach your child not to pull on the catheter tails, and to avoid getting them caught on things like clothing. Ask caregivers about other activity guidelines with a central line.

CONTACT A CAREGIVER IF:

• Your child has a fever.
  
  
• The area with the catheter is red, warm or draining.
  
  
• There is swelling of your child's neck, chest, arm or hand on the side with the catheter.
  
  
• Your child has pain in the shoulder, arm, or neck.
  
  
• Your child has pain when medicine is going into the catheter.
  
  
• It is hard to get medicines to go into the catheter, or they have started going in much slower.
  
  
• You see that the length of the catheter tails gets shorter or longer.
  
  
• Your child's arm or hand feels cold, or are white or blue.
  
  
• Your child's bandage gets loose, wet, dirty or falls off, and you don't know how to put on a new one.
  
  
• You have questions or concerns about your child's catheter.

SEEK CARE IMMEDIATELY IF:

• Your child does not stop crying or will not wake from sleeping.
  
  
• Your child has trouble breathing or your child's skin turns blue or pale.

Copyright © 2011. Thomson Reuters. 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.

Learn more about Tunneled Central Lines Child (Discharge Care)