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Tunneled Central Lines In Children
WHAT YOU NEED TO KNOW:
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 that you can see under your child's skin before it enters a large vein near his heart. A tunneled central line can stay in for several months.
WHILE YOU ARE HERE:
Before the procedure:
- You or a close family member will be asked to sign a legal document called a consent form. It gives healthcare providers permission to do the procedure or surgery on your child. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
- Vital signs: Healthcare providers will check your child's blood pressure, heart rate, breathing rate, and temperature. They will also ask you or your child about his pain. These vital signs give information about your child's current health.
- Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your child's skin record the electrical activity of his heart.
- Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your child's blood. A cord with a clip or sticky strip is placed on your child's foot, toe, hand, finger, or earlobe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your child's oxygen level is low or cannot be read.
- General anesthesia will keep your child asleep and free from pain during surgery. Anesthesia may be given through your child's IV. He may instead breathe it in through a mask or a tube placed down his throat. The tube may cause your child to have a sore throat when he wakes up.
During the procedure:
- Ultrasound and x-ray may be used to help guide placement of the catheter. Local anesthesia medicine will be used to numb the area where the catheter will be inserted. Your child may get general anesthesia to make him sleep.
- The healthcare provider will insert a needle through your child's skin until the needle reaches his vein. A guidewire is used to help place the catheter in the vein. A catheter that contains or is coated with germ-killing medicine may be used to help prevent infection.
- The needle and guidewire are removed, and the catheter is left in the vein. Healthcare providers secure the catheter to your child's skin using tape or stitches. A bandage is placed over the area to keep it clean and help prevent infection.
After the procedure:
- Chest x-ray: A chest x-ray may be done to check the location of the catheter.
- Activity: Your child's healthcare provider will tell you when it is okay to pick up your child. At first, your child's neck and shoulder may be sore.
- Your child may bleed more than expected, or the catheter may go into the wrong area or blood vessel during the procedure. Air or blood may get into the pleural (lung) cavity in the chest and cause heart or lung problems. Your child may get an infection where the catheter enters his body, or the infection may be in his bloodstream. The catheter may break, bend, or move out of place and not work. It may need to be taken out, and a new catheter put in. The catheter may go into the wrong area or blood vessel during the procedure. Air or blood may leak into the space around your child's lungs and cause heart or lung problems. The area around your child's catheter may get infected, or he may get an infection in your bloodstream. Your child's catheter may get blocked, and healthcare providers may need to remove or replace it.
- Medicine may leak on your child's skin, causing swelling, pain, or blisters. Your child 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. Your child may get a blood clot in the vein where the catheter is placed. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in his body. The blood clot may break loose and travel to the lungs. A blood clot in the lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
- If your child does not have a central line placed, he may need to get multiple needle sticks. It may be hard for your child's healthcare providers to give him the treatment he needs. Contact your child's healthcare provider if you have questions about the risks of a tunneled central line.
CARE AGREEMENT:You 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.
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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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