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Tunneled Central Lines in Children
WHAT YOU NEED TO KNOW:
A tunneled central line is a type of long-term IV catheter. A catheter is a flexible tube used to give treatments and to take blood. You can see the catheter under your child's skin before it enters a vein near his or her heart. You will need to flush and care for your child's central line as directed.
Call your local emergency number (911 in the US) for any of the following:
- Your child has pain in his or her arm, neck, shoulder, or chest.
- Your child coughs up blood.
- Your child has chest pain or trouble breathing.
Seek care immediately if:
- The catheter site turns cold, changes color, or your child cannot feel it.
- You see blisters on your child's skin around where the catheter enters it.
Call your child's doctor if:
- Your child has a fever.
- The catheter site is red, warm, painful, or is oozing fluid.
- You see blood on the bandage and the amount is increasing.
- The veins in your child's neck or chest bulge.
- You cannot flush your child's catheter, or he or she feels pain when you flush the catheter.
- You see that the catheter is getting shorter, or it falls out.
- You see a hole or a crack in the catheter. Clamp the catheter above the damage before you call your child's doctor.
- You have questions about how to care for the catheter.
What you need to remember about the central line:
The following can help prevent an infection or other problems:
- Clean and change the catheter parts as often as directed. You will be shown how to clean the caps, hubs, and injection ports. Always clean the parts before you attach and after you remove tubing from your child's catheter. Use a new alcohol pad for each part you clean. Ask his or her healthcare provider how often to change the caps and the medicine tubing.
- Flush the catheter before and after you use it. Your child's healthcare provider may give you syringes filled with saline (salt water) or heparin (a blood thinner) to flush the catheter. Stop if it is difficult to push the plunger. Do not force the saline or heparin into your catheter. This could damage the catheter or your child's vein. The force could also cause a blood clot to move into his or her blood. Stop when about 1 milliliter (mL) is left in the syringe. This will keep any air bubbles in the syringe.
- Clamp the catheter as needed. You may need to clamp the catheter at certain times, such as when the caps and tubing are being changed. The catheter is clamped to help prevent air from getting in.
- Loop and secure extra tubing. Loosely loop the tubing. Secure it to your child's arm with medical tape. This will help prevent the catheter from being pulled out by accident. Teach your child not to touch, play with, or pull on the catheter. Tell him or her why the catheter is being used. Explain that it needs to stay secured to his or her arm to keep it clean and protected.
- Ask about activity. Your child's healthcare provider will tell you which activities are safe for him or her. Your child may not be able to play contact sports until the catheter is removed.
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 central line-associated bloodstream infection (CLABSI). A CLABSI is caused by bacteria getting into the bloodstream through the catheter. This can lead to severe illness. The following are ways you can help prevent a CLABSI:
- 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 everyone who cares for your child's catheter to wash their hands.
- 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 dressing. Wear clean medical gloves when you touch your child's catheter or change the 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 him or her take showers instead of baths. Do not let your child swim or soak in a hot tub.
Follow up with your child's doctor as directed:
Your child may need to have the stitches taken out. 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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