Central Lines

A central line is a soft, flexible tube (catheter) that is used to give medicine or nutrition through a person's veins. The tip of the central line ends in a large vein (superior vena cava) just above the person's heart. Medicine given through the central line is quickly mixed with blood because the blood flow within this large vein is so great. This dilutes the medicine so it is swiftly delivered throughout the body. Insertion of any type of central line is a sterile procedure.

A central line may be placed because:

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

  • You need long-term IV medicines, such as antibiotics.  

  • 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.  

  • You need dialysis.

TYPES OF CENTRAL LINES

There are different types of central lines. The type of central line you receive depends on how long it will be needed, your medical condition, and the condition of your veins. You might receive any of these types:

  • Peripherally inserted central catheter (PICC) lines. These are usually inserted in the upper arm. They are used for intermediate to long-term access. These lines are often inserted by a specially trained nurse using ultrasonography to guide the placement.

  • Non-tunneled central lines. These are inserted in the neck, chest, or groin. They are used for short-term access, usually a maximum of 7 days. These lines are often used in the emergency department, and they can have a high infection rate.

  • Tunneled central lines. These are normally inserted in the upper chest area. They are used for long-term therapy and may be used for dialysis. These lines are inserted and removed surgically.

  • Implanted ports. These are normally inserted in the upper chest but can also be placed in the upper arm or in the stomach area (abdomen). They are used for long-term therapy. Ports are inserted and removed surgically. The person's skin heals over the port insertion site. The port must be accessed using a special needle.

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 insertion site of the central line.  

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

  • Developing an abnormal heart rhythm (rare). The heart may beat rapidly or "skip" beats.  

  • A collapsed lung during insertion (rare). 

HOME CARE INSTRUCTIONS

  • Follow your caregiver's specific instructions for the type of device that you have.

  • Keep any bandages (dressings) over the central line clean and dry. Wash your hands before a dressing change, and change dressings as directed by your caregiver. Look for redness or irritation at the insertion site during a dressing change.

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

  • Wash your hands and flush your line as directed to keep it open.  

  • If the central line accidentally gets pulled on, make sure that the dressing is okay, that there is no bleeding, and that the line has not been pulled out.  

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

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

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have chills.

  • You have a fever.  

  • You have shortness of breath or difficulty breathing.  

  • You have chest pain.  

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

  • You feel dizzy or faint.

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

  • You have 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.  

  • Your central line is difficult to flush or will not flush.

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

  • You have a hole or tear in the catheter.  

  • Your catheter leaks when flushed or when fluids are infused into it.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

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