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Peripherally Inserted Central Catheters And Midline Catheters In Children

WHAT YOU NEED TO KNOW:

A catheter is a small tube used to give treatments and to take blood. A catheter can help protect your child's veins because medicine goes through the catheter instead of through the veins. The catheter is guided into place through a peripheral vein in your child's upper arm. Peripheral veins lead from your child's arms and legs to his or her heart. A peripherally inserted central catheter (PICC) is guided into a vein near the heart. A midline catheter is inserted into one of 3 veins in your child's arm. The end of a midline does not go past the top of your child's armpit.

DISCHARGE INSTRUCTIONS:

Seek care immediately if:

  • Your child feels pain in his or her arm, neck, shoulder, or chest.
  • The catheter site turns cold, changes color, or your child says he or she cannot feel it.
  • Your child coughs up blood.
  • You see blisters on the skin near the catheter site.

Contact your child's healthcare provider if:

  • Your child has a fever.
  • The catheter site is red, warm, painful, or oozing fluid.
  • You see blood on your child's bandage and the amount is increasing.
  • The veins in your child's neck or chest bulge.
  • You cannot flush your child's 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 contact your child's healthcare provider.
  • You see a hole or a crack in the catheter. Clamp your catheter above the damage before you contact your child's healthcare provider.
  • You have questions or concerns about your child's catheter.

Medicines:

  • 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. 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.

Apply a warm compress as directed:

The area where the catheter was inserted may feel sore. A warm compress can help to decrease pain 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.

Prevent catheter-associated infections:

The area around your child's catheter may get infected. Your child may get an infection in his or her bloodstream. A catheter-associated infection is caused by bacteria getting into your child's bloodstream through the catheter. Infections from catheters can lead to severe illness. The following are ways you can help 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 catheter to wash their hands.
    Handwashing
  • Wear medical gloves. Wear clean medical gloves when you touch your child's catheter or change bandages.
  • Limit contact with the catheter. Do not touch or handle the catheter unless you need to care for it. Do not pull, push on, or move the catheter when you clean your skin or change the bandage. Also remind your child not to touch the catheter or the area around it.
  • Clean your child's skin as directed. Clean the skin around the catheter every day and just before you change the bandage. Ask your healthcare provider what to use to clean your child's skin.
  • Check for signs of infection. Check your child's skin every day for signs of infection, such as pain, redness, swelling, and oozing. Contact your child's healthcare provider if you see these signs.
  • Cover the area. Keep a sterile bandage over the catheter site. Change the bandage as directed or when it is loose, wet, dirty, or falls off. Change your child's bandage in a place away from open windows, heating ducts, and fans. Be sure it is well-lit, clean, and free of dust. Clean the skin under the bandage with the solution your child's healthcare provider suggests. Let the area dry before you put on the new bandage.
  • Keep the area dry. Do not let your child's catheter or catheter site get wet. Wrap your child's arm with plastic and seal it with medical tape before he or she bathes. Ask if your child should take showers instead of baths. Do not let your child swim or soak in a hot tub.

Follow up with your child's healthcare provider as directed:

Write down your questions so you remember to ask them during your child's 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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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