Central Line Care
A central line is an IV that is inserted for long-term use. Types of central lines include surgically implanted ports (port-a-cath), Hickman catheters and PICC lines. These catheters are long tubes, with one end sitting inside a vein near your heart and the other end exiting through the skin in your upper arm, chest or neck. Your oncology team may suggest a central line if you are receiving certain chemotherapy agents, frequent lab draws, long-term antibiotics, intravenous nutrition, having a stem cell collection or if it has become too difficult to get an IV in your veins. It is a good idea to write down what type of central line was placed, who placed it and when it was placed. You may be asked for this information throughout your treatment course.
You may have a central line placed while in the hospital or as an outpatient, and you will most likely go home with this line in place. Therefore, you will need to learn to care for this device. In many cases, you will be visited by a home care nurse to care for the line or teach you (or your caregiver) to care for it. A port-a-cath that is not being used at home is the exception because it requires no care. It is best for you and anyone else involved in your care to be aware of a few things while you are living with a central line:
Get to know your line: look at it.
A central line is a direct portal into your veins. The most common complications of central lines are infection and a clot in the catheter (occlusion). Occlusion is a blockage in your line, which makes the catheter unusable and can interrupt your treatment. Each day you should look at your central line to check for any changes to the dressing, the insertion site (place where it enters the skin) and the lumens (tubes). Ensure your dressing is intact and not wet or dirty. Signs and symptoms of infection may be seen at the insertion site and include redness, swelling, drainage, bruising and bleeding. Look at the lumens to ensure that they are intact and not leaking. If you are experiencing any of these symptoms, pain or fever, notify your health care provider immediately.
Taking care of your central line.
You (or your care provider) should never touch your central line without first washing your hands. When using or flushing the lumens or changing the dressing, hands should be washed and gloves should be worn. Central lines need to be flushed as directed to maintain patency and the dressing should be changed at least once a week and as needed (if it gets dirty or wet). A home care nurse will be sent to your home to teach you to care for the central line catheter. Each home care agency has procedures and policies that guide their practice regarding flushing and dressing changes. Your nurse should provide teaching and written materials to guide your central line care at home.
Keep it dry.
Your central line, including implanted ports IF they are accessed with a needle, should not come in contact with any water or moisture. Getting your central line wet can lead to an increase in the frequency of dressing changes and risk of infection. There are covers and sleeves available through most home care companies to keep the area dry when showering. If your central line dressing does get wet, soiled or has loosened, it should be changed as soon as possible to prevent infection.
Live your life.
Live your life! However, you may need to make some changes to avoid damaging the line. Avoid heavy lifting and having blood pressures taken in the arm with your central line. Do your best to avoid pulling or tugging on the lumens (or access needle) of your central line. This can cause damage to the central line. There are mesh sleeves and line stabilizers available through most home care agencies. If your line is in your arm, you can cut the foot portion off of a long sock and pull the leg portion of the sock up around your arm to cover your central line. Make sure to not pull on the lumens while doing so – you may need a helper.
Call your provider if concerns arise.
Having a central line may seem scary at first and you may have to make adjustments to your daily life. However, with proper care, your central line can make treatments easier for you and your healthcare team. If you have any questions or concerns about your central line notify your home care provider or medical provider.
For additional information regarding central catheters, visit the Vascular Access Management website.
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Vascular Access Mangement. Caring for Your PICC Line: What Patients Need to Know. PICC Line Nursing. Retrieved July 23, 2014, from picclinenursing.com/picc_care.html
Weingart, S., Hsieh, C., Lane, S., Cleary, A. (2014). Standardizing central venous catheter care by using observations from patients with cancer. Clinical Journal of Oncology Nursing, 18 (3), 321-326.