Central Line Care

What is a Central Line?

A central line, or central venous catheter, is an intravenous (IV) device that gives access to your veins. A central line can stay in your body (weeks or months) longer than a peripheral IV (a temporary IV often placed in your hand or arm). Types of central lines are:

• Surgically-implanted ports (port-a-cath).
• Hickman catheters (tunneled central venous catheter).
• PICC lines.

Central lines are long, flexible tubes, with one end 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 getting chemotherapy.  
• You need blood or platelet transfusions.
• You need frequent lab draws. 
• You will be on long-term antibiotics. 
• You are getting IV nutrition. 
• You will be having a stem cell collection. 
• It is hard for your care team to place an IV in your veins. 

It is a good idea to write down what type of central line you have, 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 when you are in the hospital or as an outpatient. You will most likely go home with this line in place. A port-a-cath that is not being used requires no care, but if you have another type of central line, you will need to learn to care for it.  You may have a home care nurse come to your home to care for the line or teach you (or your caregiver) how to care for it. There are a few important things for you and your caregivers to know about your central line:

Get to know your line: Look at it.

A central line gives direct access to your veins. The most likely complications are infection and a clot in the catheter (occlusion). 

• Infection signs and symptoms are most often seen at the insertion site (the place where it enters the skin). These are things like redness, swelling, drainage, bruising, and bleeding. 
• 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, and the lumens (tubes). Make sure your dressing is not ripped, broken, wet, or dirty. Look at the lumens to make sure that they are not broken or leaking. If you have any symptoms of an infection, have pain or a fever, call your healthcare team right away.

Taking care of your central line.

Always wash your hands before touching your central line. Central lines need to be flushed to stay 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 can 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 give you teaching and written materials for your central line care at home.

Keep it dry.

Your central line and 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 more dressing changes and a higher risk of infection. You can get covers and sleeves through most home care companies to keep the area dry when showering. If your central line dressing does get wet, soiled, or loose, it should be changed as soon as possible to prevent infection.

Protect your central line.

You may need to make some changes to avoid damaging your line.

• Do not lift anything heavy.
• Do not have your blood pressure taken on the arm with your central line.
• Do not pull or tug on the lumens (or access needle) of your central line. This can cause damage to the central line.
• Use mesh sleeves and line stabilizers to protect your central line. These are available through most home care agencies. If your line is in your arm, you can also cut the foot portion of a long sock and pull the leg part of the sock up around your arm to cover your central line. Make sure to not pull on the lumens when doing this. You may need to ask someone to help.

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. 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, tell your home care provider or healthcare team.