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.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about central lines. You can then discuss choices with your child's caregivers. Work with them to decide what choices may be best for your child.

RISKS:

• There are always risks with any medical procedure. Your child may bleed or get an infection (in-fek-shun). Your child may have trouble breathing or get blood clots. Caregivers will watch your child closely for these problems. The end of the catheter may move or become damaged or blocked. If this happens, your child may need to have another catheter put in.
  
  
• The catheter may damage your child's arm. If IV fluid leaks out of the catheter into your child's body, your child could get an infection. Air could get into your child's blood through the catheter, or your child could get an irregular heartbeat. Rarely, your child's lung may collapse or the catheter can break apart. Your child may die. Call your caregiver if you are worried or have questions.

WHILE YOU ARE HERE:

Before the Procedure:

• Informed Consent:
  
  
  • You have the right to understand your child's health problem. You should understand what tests, treatments, or procedures may be done to treat your child's problem. Your child's caregiver should also tell you about the risks and benefits of each treatment.
    
    
  • You may be asked to sign a consent form. If you are unable to give your consent, someone who has permission can sign this form for your child. A consent form is a legal paper that gives a caregiver permission to do certain tests, treatments, or procedures. This form should tell you exactly what will be done to your child. Your child's caregiver should explain what the risks and benefits of each treatment are before you sign the form. Before giving your consent, make sure all your questions have been answered. This way you will understand what may happen to your child.
  
  

• Blood Tests: Your child may need blood taken for tests. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV. Your child may need to have blood drawn more than once.
  
  

• Call Button: A call button will be in your child's hospital room. You or your child should use the call button if your child is having problems and a caregiver is needed. You can also use the call button if you or your child have questions for a caregiver. Be sure to keep the call button near you or your child at all times.
  
  
• Gown: A hospital gown is needed so caregivers can easily check and treat your child. Your child's gown should be put on so it opens in the back. Your child may be able to wear regular pajamas or clothes when he feels better.

• Chest X-ray: This is a picture of your child's lungs and heart. Caregivers use it to see how your child's lungs and heart are doing. The chest x-ray can show problems such as: pneumonia (new-moan-yuh), tumors, fluid around the heart, or a collapsed lung. It also shows caregivers if the catheter is in the right place.
  
  

• Heart Monitor: This is a machine used to see how your child's heart is doing. Some small sticky pads are placed on your child's chest. Each pad has a wire that is hooked to a TV-type screen or to a small portable box. This screen or box shows a picture of your child's heartbeat. Caregivers watch this picture to make sure your child's heart is doing well.
  
  

• Pulse Oximeter (oks-ih-mih-ter): This is a machine that tells caregivers how much oxygen is in your child's blood. A cord with a clip or sticky strip is placed on your child's foot, toe, hand, finger, or earlobe. Tell a caregiver if the sticky strip or clip comes off of your child. The machine will alarm if the machine cannot read the oxygen level or if your child needs more oxygen. Tell a caregiver if the machine is alarming. Never turn the pulse oximeter off unless a caregiver has said it is OK.
  
  

• Vital Signs: This may include taking your child's temperature, pulse (heartbeats), respirations (breaths), and blood pressure. Your child's temperature may be taken in the mouth, ear, armpit, or rectum (rear-end). Caregivers may also listen to your child's heart and lungs by using a stethoscope (steth-uh-skop).
  
  

• General Anesthesia (an-iss-thee-zuh): This is medicine to make your child comfortable and sleep during the procedure. The medicine may be given as a liquid or in an IV. It can also be given as a breathing gas through a facemask. It may also go through a tube placed in your child's mouth and throat. This tube is called an endotracheal (end-o-tra-kee-ull) tube or "ET tube". Ask your child's caregiver for the anesthesia CareNotes™ handout if you want to know more about anesthesia.
  
  

During the Procedure:

• Your child will be given medicine to make him sleep. Your child may have to lie down with his head lower than his feet. This makes neck veins easier to see. Your child's caregiver will clean the area where the catheter will go with yellow soap. The soap will be cleaned off later. Towels will be put over the area.
  
  
• A special x-ray will be used to put in the catheter so doctors can see that it goes into the right place. Your child's doctor will make a small incision (cut) through your child's skin. The catheter will be put into the incision and tunneled under your child's skin into a vein.
  
  
• An x-ray may be taken to make sure the catheter is in the right place. The doctor may use stitches (thread) to sew the catheter to your child's skin. The stitches keep the catheter in the right place. Bandages will be put on to keep the area clean and dry.

After the Procedure:

• Activity: Your child's caregiver will tell you when it is OK to pick up your child. At first, your child's neck and shoulder may be sore.
  
  
• Catheter Cap: Your child may have one or more tails 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.

• Removing the Tunneled Central Line: Your child's doctor will remove the catheter. Your child will have a dressing over the area where the catheter was after it is removed. Your child may need to have another catheter put in. Your child's tunneled central line may be removed when:
  
  
  • A different type of catheter is needed.
    
    
  • The catheter is causing an infection (in-fek-shun).
    
    
  • Your child no longer needs the IV medicines.
    
    
  • Your child's catheter is blocked or no longer works right.
  
  

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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