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Midline Catheter in Children
What you need to know about a midline catheter:
A midline catheter is a small tube used to give treatments and to take blood samples. The catheter is inserted into a vein in your child's arm. The end of a midline, inside your child's body, does not go past the top of his or her armpit. A midline catheter can stay in place for up to 30 days.
How a midline catheter is placed:
- Your child will get local anesthesia to numb the area. The catheter will be put into a vein. It will be guided up until the tip is in a vein near his or her armpit. The other end of the catheter will stay outside your child's body.
- The catheter will be secured to your child's skin with a dressing. The dressing holds it in place, keeps it clean, and helps prevent infection. The dressing will be clear so you can check the insertion site for signs of infection.
- Healthcare providers will watch for problems during the midline catheter placement. Your child could have bleeding when the catheter is inserted. An infection could develop at the insertion site. An infection that enters the bloodstream can cause serious illness.
Prevent an infection:
The area around the catheter may get infected, or your child may get an infection in his or her bloodstream. A bloodstream infection is called a catheter-related bloodstream infection (CRBSI). A CRBSI is caused by bacteria getting into the bloodstream through the catheter. This can lead to severe illness. The following are ways to prevent an infection:
- Wash your hands and your child's hands often. Use soap or an alcohol-based hand rub. Clean your hands before and after you touch the catheter or the catheter site. Remind anyone who cares for your child's catheter to wash his or her hands. Teach your child not to handle or play with the catheter.
- Limit contact with the catheter. 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 his or her skin or change the dressing. Wear clean medical gloves when you touch the catheter or change dressings.
- Keep the area covered and dry. Keep a sterile dressing over the catheter site. Wrap the insertion site with plastic and seal it with medical tape before your child bathes. Have your child take showers instead of baths. Do not let your child swim or soak in a hot tub.
What healthcare providers will teach you and your child about the midline catheter:
- Supplies you need to keep on hand to use, care for, and flush the catheter
- How to use the catheter, and when to keep it clamped
- How and when to flush and care for the catheter
- Problems that may develop, such as a hole in the catheter, and what to do to fix the problems
- How to bathe and do daily activities with a midline catheter in place
- How to prevent infections
- Signs and symptoms of an infection to watch for and what to do if an infection develops
Call your local emergency number (911 in the US) for any of the following:
- Your child feels pain in his or her arm, neck, shoulder, or chest.
- Your child coughs up blood.
Seek care immediately if:
- The catheter site turns cold, changes color, or your child cannot feel it.
- You see blood on the dressing and the amount is increasing.
- The veins in your child's neck or chest bulge.
Call your child's doctor if:
- You see signs of infection, such as redness, swelling, or pus, or your child has a fever.
- The catheter site is red, warm, painful, or oozing fluid.
- You see blisters on the skin near the catheter site.
- You cannot flush the catheter, or your child feels pain when you flush the catheter.
- You see that the catheter is getting shorter, or it falls out. Put pressure on the site with a clean towel before you call your child's doctor.
- You see a hole or a crack in your child's catheter. Clamp the catheter above the damage before you call your child's doctor.
- You have questions or concerns about your child's catheter.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
- 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.
- Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.
Care for your child:
- Help your child rest when he or she gets home. Your child should be able to do his or her normal activities the next day. Your child's healthcare provider will tell you which activities are okay for your child.
- Apply a warm compress as directed. 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 or she is sitting or lying down. This will decrease swelling.
- Follow instructions on how to care for the insertion site. Your child's provider will tell you when it is okay to shower or bathe. This is usually after about 1 week. Your child will need to keep the area covered so it stays dry when he or she bathes.
Follow up with your child's doctor as directed:
Write down your questions so you remember to ask them during your visits.
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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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