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Peripherally Inserted Central Catheters And Midline Catheters In Children
WHAT YOU NEED TO KNOW:
What do I need to know about peripherally inserted central catheters and midline catheters?
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.
How do I prepare my child to have a catheter inserted?
- Tell healthcare providers if your child is allergic to latex or has any other allergies. Tell them if your child had radiation or surgery on his or her chest, or any problems with a PICC or midline catheter. Also tell them if your child has ever had an allergic reaction to contrast liquid. Tell the provider if your child has ever had a reaction to anesthesia or other sedating medicine.
- Talk to your healthcare provider about all medicines your child takes. He or she may need to stop taking certain medicines a few days before your procedure. Examples include aspirin, NSAIDs, and prescription blood thinners.
- Your child may need treatment for medical problems, such as an infection or a bleeding condition. Your child's healthcare provider may use an ultrasound to find your child's veins. He or she will also make sure the veins are healthy enough for a catheter.
- You may be told not to let your child eat or drink anything for about 6 hours before the procedure. Your child's healthcare provider will give you specific instructions to follow, depending on your child's age. The instructions will also include medicines your child can take or not take on the day of the procedure.
What will happen during the procedure?
- Depending on your child's age, he or she may get general anesthesia or local anesthesia. General anesthesia will keep him or her asleep and free from pain during the procedure. Local anesthesia will numb the area. Your child will be awake during the procedure if local anesthesia is used. He or she may feel pressure or pushing during the procedure but should not feel pain. Talk to your child about how this procedure is done. Your child may be afraid of pain because a needle is used for this procedure. Explain how the medicine will help prevent pain.
- A band will be tightened around your child's arm. This helps your child's healthcare provider see his or her veins. The band also stops blood from flowing into the vein while healthcare providers place the catheter.
- Your child's healthcare provider will put a needle through your child's skin and into a vein. The provider may use an ultrasound or x-ray to place the catheter correctly. Have your child tell the provider if he or she feels pain or tingling while the catheter is being placed.
- The needle and sheath (covering) will be removed, and the catheter will be left in the vein. Healthcare providers may secure the catheter to your child's skin with tape or stitches. A new bandage will be placed over the area to keep it clean and to help prevent infection.
What will happen after the procedure?
If your child has a PICC, a chest x-ray will be done to show healthcare providers the location of the catheter tip. Your child may be able to go home after the procedure. Have your child rest when he or she gets home. He or she should be able to go back to your normal activities the next day. Your child's healthcare provider will tell you which activities are okay for him or her. Do not let your child lift heavy objects. You will get instructions on how to care for your child's incision wound, and when it is okay to shower or bathe. This is usually after about 1 week.
What are the risks of having a PICC or midline catheter?
- More than one attempt may be needed to place the catheter. The vein where the catheter is placed may become irritated, and your child's skin may get red, painful, and blister. When the catheter is put in, your child's vein may tear, or the catheter may injure a nerve. Your child's catheter may get blocked, and healthcare providers may need to remove or replace it.
- The catheter may break, bend, or move out of place. The IV medicine may leak outside the vein and cause pain, swelling, or blisters. Your child can have bleeding, an allergy to heparin, or heparin-induced thrombocytopenia (HIT). HIT is a low number of blood platelets. This increases the risk of bleeding. Your child may get a blood clot in his or her arm. These problems can be life-threatening.
Care AgreementYou have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. 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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