Central Line Care
What is a Central Line?
A central line is an IV that is inserted for long-term use. Types of central lines include:
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.
- Having frequent lab draws.
- On long-term antibiotics.
- Getting intravenous (IV) nutrition.
- Having a stem cell collection.
- 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.
You may have a central line placed while in the hospital or as an outpatient. 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.
- Infection signs and symptoms are most often seen at the insertion site (the place where it enters the skin). These include redness, swelling, drainage, bruising, and bleeding.
Each day you should look at your central line to check for any changes to the dressing, the insertion site, and the lumens (tubes). Make sure your dressing is intact and not wet or dirty. Look at the lumens to ensure that they are intact and not leaking. If you are having any of these symptoms, have pain or a fever, call your health care provider right away.
Taking care of your central line.
You (or your care provider) should never touch your central line without first washing your hands. Central lines need to be flushed as directed to maintain patency (remain open and usable). Flushing is done with saline or a heparin/saline mix and pushed into the lumen through a syringe. When using or flushing the lumens or changing the dressing, hands should be washed and gloves should be worn. 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 for flushing and dressing changes. Your nurse will provide teaching and written materials to guide your central line care at home.
Keep it dry.
Your central line, including implanted ports that are accessed with a needle, should not come in contact with any water or moisture. Getting your central line wet can lead to the need for more dressing changes and a higher 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 you have questions or concerns.
Having a central line may seem scary at first and you may have to make changes 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 care team.
Camp-Sorrell, Dawn (2007). Clinical dilemmas: vascular access devices. Seminars in OncologyNursing, 23 (3), 232-239.
Kramer, N., Doellman, D., Curley, M. & Wall, J. (2013). Central vascular access device guidelines for pediatric home-based patients: driving best practices. Journal of the Association forVascular Access, 18 (2), 103-113.
Lyons, M. & Phalen, Ann G. (2014). A randomized controlled comparison of flushing protocols in Home care patients with peripherally inserted central catheters. Journal of InfusionNursing, 37 (4), 270-281.
Vascular Access Mangement. Caring for Your PICC Line: What Patients Need to Know. PICC Line Nursing. 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.