Central Lines

A central line is a soft, flexible tube that is placed because you need intravenous (IV) access. The tip of the central line ends in a large vein (superior vena cava) just above the heart. Because the blood flow within this vein is so great, medicine that is given through the central line is quickly mixed with blood. This dilutes the medicine so it is swiftly delivered throughout your body. Insertion of any type of central line is a sterile procedure.

A central line may be placed because:

  • You need medication that would be irritating to the small veins in your hands or arms.

  • You need long-term intravenous (IV) antibiotics or other IV drugs.

  • You need nutrition delivered through a central line.

  • You have veins in your hands or arms that are difficult to access.

  • You need frequent blood draws for lab tests.

TYPES OF CENTRAL LINE DEVICES

There are different types of central lines. The type of central line you get depends on how long it will be needed, your medical condition, the condition of your veins and what type central line is best for you.

The types of central lines include:

  • Peripherally Inserted Central Catheter (PICC) lines are usually inserted in the upper arm.

  • Ultrasound is used to guide insertion of the PICC line.

  • Used for intermediate to long term access.

  • Usually inserted by a specially trained nurse.

  • Non-tunneled central lines are inserted in the neck, chest or groin.

  • Used for the short-term access, usually 7 days.

  • Can be inserted in the patient's room.

  • Can have a high infection rate.

  • Tunneled central lines are normally inserted in the upper chest area.

  • Used for long term therapy.

  • Are inserted and removed surgically in a special procedure room.

  • Different types of tunneled central lines are Hickman Catheter, Broviac Catheter, Groshong Catheter.

  • Can be used for dialysis.

  • Implanted ports are normally inserted in the upper chest but can be placed in the upper arm or in the stomach area (abdomen).

  • Used for long term therapy.

  • Are inserted and removed surgically in a special procedure room.

  • Your skin heals over the port insertion site.

  • The port must be accessed by a special "portacath" needle.

HOME CARE INSTRUCTIONS

Follow your caregivers specific instructions for the type of device that you have.

  • If you have a dressing over your central line, be sure to keep it clean and dry.

  • Keep the insertion site of your central line clean at all times.

  • Change your dressing over the central line as instructed by your caregiver. Wash your hands with soap and water before changing the dressing. In order to know you have washed for a long enough time, sing "Happy Birthday" while doing so. When you are finished singing to yourself, you have washed for the right amount of time.

  • When you change the dressing, check for redness or irritation. Call your caregiver if there is pus-like discharge, redness, swelling, or discomfort where the central line enters the skin.

  • Flush your line as instructed to keep it open (patent).

  • If the central line accidentally gets pulled, check to make sure the dressing is okay. If there is bleeding or the line looks like it has been pulled out, call your caregiver.

  • Limit lifting, using your arm or other activity as told by your caregiver.

  • Swim or bathe only if given permission. Your caregiver can instruct you on how to keep your specific type of dressing from getting wet.

RISKS AND COMPLICATIONS

Any type of central line has risks that you should be aware of. Some of these include:

  • Infection.

  • Clotting of the central line.

  • Bleeding from the central line insertion site.

  • Developing a hole or crack within the central line. If this happens, the central line will need to be replaced.

  • In rare cases, you can develop an abnormal heart rhythm. Let your caregiver know right away if you feel your heart beating rapidly or "skipping" beats.

  • When a central line is being inserted in the chest area, a collapsed lung (pneumothorax) can occur. This is a rare problem.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop chills or a fever of 100.5° F or greater.

  • You develop shortness of breath or difficulty breathing.

  • You develop chest pain.

  • You feel your heart beating rapidly or "skipping" beats.

  • You develop dizziness or you pass out.

  • You develop bleeding from the insertion site that does not stop.

  • There is pain, redness, swelling or drainage at the insertion site of the central line.

  • You have swelling in your neck, face, chest or arm on the side of your central line.

  • The central line is not working properly such as:

  • It will not flush.

  • You do not get a blood return from the central line.

  • You develop a hole or tear in the catheter.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.