Tunneled Central Lines Child

WHAT YOU SHOULD KNOW:

• A tunneled central line is a type of catheter (kath-uh-ter). A catheter is a small flexible plastic tube. The catheter is put in and tunneled a short distance under your child's skin.Your child's doctor may put the catheter into a vein near your child's 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 3 small tails (tubes) hanging out. These tails may 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 written list of what medicines your child takes and when and why your child takes them. Bring the list of your child's medicines or the pill bottles when you visit your child's caregivers. Ask your child's caregiver for more information about the medicines. Do not give any medicines to your child without first asking your child's caregiver. This includes prescriptions, over-the-counter drugs, vitamins, herbs, or food supplements.
  
  
• Always give your child's medicine as directed by caregivers. Call your child's caregiver if you think your child’s medicines are not helping.Call your child's caregiver if you feel your child is having side effects. Do not quit giving the medicines to your child until you discuss it with your child's caregiver. If your child is taking antibiotics (an-ti-bi-ah-tiks), give them until they are all gone. Even if your child seems to feel better.
  
  
• Never give aspirin to your child without first asking your child's caregiver. Giving aspirin to your child when he is ill may cause a very serious illness called Reye's syndrome. Read medicine labels to see if your child's medicine has aspirin.

Activity: 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 avoid getting them caught on things like clothing.

Air in the Catheter: Air should not get into your child's catheter. Make sure all tubes are tightly connected. You may also tape these connections so they stay together.

Appointments:

Ask your child's caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you and your child may have. This way you will remember to ask these questions during your child's next visit.

Bandages and Bathing:

• Your child's caregiver will change the bandage over the catheter, or you may be taught how to change it. There must be a bandage on at all times. If the bandage comes off and you do not know how to put a new one on, call your child's caregiver. Bandages are usually changed 1 or 2 times a week. Your child's bandage also needs to be changed if it gets loose, wet or dirty.
  
  
• Until the catheter area is completely healed, it must be kept dry at all times. Your child may bathe when the catheter is not being used. Cover the catheter and dressing with plastic to keep it dry. After the area is healed, you may gently wash the area with mild soap and water. Rinse and dry it well. Put a new bandage over the catheter. If your child wants to swim, check with your child's caregiver.

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.

Flushing Your Child's Catheter:

• Ask your child's caregiver what medicine to use to flush the catheter. Saline solution is often used. Ask him when and how often to flush the catheter. Flushing means to push fluid out of a syringe. To do this, screw or push a syringe into the plastic end of your catheter tail. Use the plunger to slowly push the fluid out of the syringe into the catheter. Always clean the catheter cap as your caregiver has shown you before using it.
  
  
• Usually you will follow the "SASH" rule for flushing. This is S aline solution, followed by the A ntibiotic (or other medicine). When the medicine has finished, flush with S aline solution, then finish by flushing with H eparin. Your child's caregiver may ask you to check the length of the tails from the catheter. If you see the length is longer or shorter than what it was, call your child's caregiver.

Medicine Pump: Your child may get medicine all the time through a pump. If so, you do not need to unhook and flush the catheter. You may be taught how to attach medicine to the pump.

Catheter Cap: Your child will have 1 or 2 tails (tubes) hanging from the place where the catheter was put in. Caps are at the end of these tails to keep the tubes closed and clean. You may be taught how to replace the caps with new ones.

Infusion Center: An Infusion Center is a place where you may take your child to get IV medicines or treatments. Catheters can be put in and removed there. If your childs catheter is not working, you may go to an Infusion Center to get help. Your child's caregiver will tell you where Infusion Centers are located.

Needleless IV system: A needleless intravenous (IV) system is used to give fluid and medicine in your IV line. It may sometimes be used to take blood out of your IV line also. With a needleless system, there are no needles used and there is no chance of poking yourself. Plastic ends of your medicine container or syringes are pushed or screwed into the caps on your catheter tails.

Using your Child's Central Line: Your child may go to an Infusion Center or clinic to get medicines and fluids through the catheter. A caregiver may come to your home to teach you how to do this for your child. Following are steps for using your child's catheter:

• Wash your hands well with soap and water. Put on clean plastic gloves if you have them. Gather all the supplies you will need.
  
  
• If your child's catheter has more than one tail, pick the tail that you should use. Your child's caregiver will tell you what tails to use for what medicines.
  
  
• Prepare the medicine that your child will be getting. Some medicines have to be kept in the refrigerator. You may need to take the medicine out ahead of time so it warms up.
  
  
• Clean the cap of the catheter and syringe as shown by your child's caregiver. Do not touch the ends or let them touch anything after they have been cleaned.
  
  
• Be sure the tubing is not clamped shut. Hold the syringe with the flush liquid in one hand, using the other hand to hold the catheter tail. Screw or push the ends together firmly. Flush the catheter. Remove the syringe from the catheter. Clean the cap on the catheter tail.
  
  
• Screw or push the end attached to the IV medicine into the catheter end. Start the machine to give the medicine or adjust the flow of the medicine. Be sure the tubing is not clamped, split or kinked. Let the medicine go in as shown to you by your child's caregiver.
  
  
• If the medicine comes in a syringe, screw or push the syringe into the catheter cap. Be sure it is tight. Push your medicine into the catheter slowly as shown by your child's caregiver.
  
  
• When the medicine is finished going in, unscrew or pull apart the two ends. Flush the catheter and close the clamp on the tubing.

CONTACT A CAREGIVER IF:

• Your child has a fever (increased body temperature).
  
  
• The area with the catheter is red, warm or draining. These are signs of infection.
  
  
• 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. Air may have gotten into the catheter. You should:
  
  
  • Clamp (close off) the catheter.
    
    
  • Lie your child down on the left side with your child's head lower than his feet.
    
    
  • Call 911 or 0 (operator) to have the ambulance take your child to the nearest hospital or clinic.

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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