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Tunneled Central Lines In Adult


What is a tunneled central line?

A tunneled central line is a type of IV catheter. A catheter is a flexible tube used to give treatments and to take blood. A tunneled central line is a catheter you can see under your skin before it enters a vein near your heart.

Why may I need a tunneled central line?

  • You need long-term IV therapy: A catheter has one or more lumens (openings). Healthcare providers can give you medicine, take blood, or do other tests through these openings. Tunneled central lines can stay in place longer than some other types of IV catheters. Healthcare providers can give you medicine such as IV antibiotics or chemotherapy for several months. You can also get TPN (liquid food) and IV liquids through a tunneled central line.
  • Your veins need to be protected: Healthcare providers may have a hard time placing an IV if your veins are small or damaged. You may also need medicine that could harm your skin or small veins. Your skin and veins are protected when the medicine goes through the catheter instead.
  • You often need blood transfusions or blood drawn for tests: You can receive blood through the catheter. Healthcare providers can also take blood samples. You will not have a needle put into a vein each time. Healthcare providers will use the catheter instead.

How can I prevent catheter-associated infections?

The area around your catheter may get infected, or you may get an infection in your bloodstream. A catheter-associated infection is caused by bacteria getting into your 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: Use soap or an alcohol-based hand rub to clean your hands. Clean your hands before and after you touch the catheter or the catheter site. Ask your healthcare provider for information on how to wash your hands. Remind anyone who cares for your catheter to wash their hands.
  • Wear medical gloves: Wear clean medical gloves when you touch your catheter or change the bandages.
  • Limit contact: Do not touch or handle your 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.
  • Clean your skin: Clean the skin around your catheter every day and just before you change your bandage. Ask your healthcare provider what to use to clean your skin.
  • Check for infection: Check your skin every day for signs of infection, such as pain, redness, swelling, and oozing. Contact your healthcare provider if you see these signs.
  • Cover the area: Keep a sterile bandage over the catheter site for as long as your healthcare provider directs. You may no longer need a bandage after your catheter site heals. Change the bandage as directed or when it is loose, wet, dirty, or falls off. Change your 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 healthcare provider suggests. Let the area dry before you put on the new bandage.
  • Keep the area dry: Do not let your catheter or catheter site get wet. Wrap your arm with plastic and seal with medical tape before you bathe. Ask if you should take showers instead of baths.

How do I care for my tunneled central line?

Your healthcare provider may want you to do the following to reduce your risk of infection or complications:

  • Clean the catheter parts: Clean the caps, hubs, and injection ports before you attach and after you remove tubing from your catheter. Open the package that contains the new alcohol pad. Put on new medical gloves. Use a new alcohol pad for each part you clean. Throw away used alcohol pads.
  • Flush your catheter: Your healthcare provider may give you syringes filled with saline (salt water) or heparin (a blood thinner) to flush your catheter.
    • Attach the syringe that contains the flushing solution to the end of the catheter tubing. Slowly push the fluid out of the syringe and into the catheter. Throw the syringe away. Clean the end of the catheter or cap with a new alcohol pad.
    • Do not force the fluid. Forcing the plunger could damage the catheter, or release a blood clot from the end of the catheter. Straighten any kinks in the tubing. Call your healthcare provider if it is still hard to push fluid into the catheter.
  • Change the caps and medicine tubing: You may need extra tubing to get medicine. Ask your healthcare provider how often to change the caps and the medicine tubing.
  • Clamp the catheter: You may need to clamp your catheter at certain times, such as when the tubing is being changed. The catheter is clamped to help prevent air from getting in.
  • Loop extra tubing: Loosely loop the tubing together. Secure it to your arm with medical tape. This will help prevent the catheter from being pulled out of your arm by accident.

What are the risks of a tunneled central line?

  • When the catheter is put in, your vein may tear, or the catheter may injure a nerve. The catheter may go into the wrong area or blood vessel during the procedure. Air or blood may leak into the space around your lungs and cause heart or lung problems. The area around your catheter may get infected, or you may get an infection in your bloodstream. Your 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 your vein and cause pain, swelling, or blisters. You can have bleeding, an allergy to heparin, or heparin-induced thrombocytopenia (HIT). HIT is a low number of blood platelets, which increases the risk of bleeding. You may get a blood clot in your arm. This can cause pain and swelling, and can stop blood from flowing where it needs to go in your body. The blood clot may break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  • If you do not have a catheter placed, you may need to get multiple needle sticks. It may be hard for healthcare providers to give you the treatment that you needs. Your condition may get worse, or you may die. Contact your healthcare provider if you are worried or have questions about having a tunneled central line.

When should I contact my healthcare provider?

Contact your healthcare provider if:

  • Your child has a fever.
  • The catheter site is red, warm, painful, or oozing fluid.
  • You see blood on your bandage and the amount is increasing.
  • The veins in your neck or chest bulge.
  • You cannot flush your catheter, or you feel pain when you flush your catheter.
  • You see that the catheter is getting shorter, or it falls out. Put pressure over the site with a clean towel.
  • You see a hole or a crack in your catheter. Clamp the catheter above the damage before you contact your healthcare provider.
  • You have questions about how to care for your catheter.
  • You run out of supplies to care for your skin or catheter.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have pain in your arm, neck, shoulder, or chest.
  • The catheter site turns cold, changes color, or you cannot feel it.
  • You see blisters on your skin around where the catheter enters it.
  • You have chest pain or trouble breathing that is getting worse over time.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.