An intravenous central line is a kind of intravenous (IV) line used to give medicines and fluids. It is a thin, soft, plastic tube called a catheter that is inserted through the skin and into a vein. It is usually put in the neck or chest just below the collarbone. Sometimes it is put in the arm. Your healthcare provider gently pushes the tube through the vein until the tip is in one of the large “central” veins near the heart. This is why it is called a central line or central venous catheter.
A central line may be used to give medicine, fluids, or nutrition for many days, weeks, or months. It is most often used when your child needs to receive fluids and medicine (such as antibiotics) for more than a few days—for example, after major surgery or for cancer treatment. IVs that are put into smaller veins need to be changed every few days to prevent infection. When your child has a central line, a new IV won’t need to be started every few days. Central lines are put into larger veins and don’t need to be changed as often. Using larger veins may also help prevent irritation and collapse of veins from some medicines. Your child may be able to go home with a central line and be given some medicines at home.
A central line may also be used to draw blood. Then your child won’t have to be poked with a needle each time a blood test needs to be done.
The 3 main types of central lines are:
How do I prepare my child for insertion of the central line?
Before the catheter is inserted, your healthcare provider will clean your child’s skin and follow steps to prevent an infection. Your child will be given a local anesthetic to numb the area or medicine to help your child relax.
The catheter will be threaded though a needle into the vein. Your provider may use ultrasound and X-rays to watch the catheter as it is moved through the vein. X-rays may also be taken after the procedure to make sure the line is in the right position. When the catheter is in the right position, it may be stitched into place and covered with a clear bandage to prevent infections. If your child has an implanted port, your provider will make a small cut in the skin so the port can be placed under the skin. The cut will be stitched closed and covered with a bandage.
The procedure takes about 30 minutes not counting the time to prepare the skin and place the sterile drapes.
Whether your child is in the hospital or at home, there are 2 important steps to caring for a central line:
When the central line is no longer needed, your healthcare provider will pull the catheter out of the vein and then put pressure on the spot where it entered the skin to stop bleeding. If your child has an implanted port, a small cut will have to be made to remove it. Your child will be given a local anesthetic before the cut is made. Your healthcare provider will close the cut after the port is removed.
Ask your healthcare provider how to take care of your child at home and when your child can return to normal activities. Ask what symptoms you should watch for and what precautions you should take. Make sure you know when your child should come back for a checkup.
What are the risks of this procedure?
Your healthcare provider will explain the procedure and any risks. Some possible risks include:
You can get more information about catheter-associated infections from the Centers for Disease Control (CDC) Web site: http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/BSI_tagged.pdf.
There is risk with every treatment or procedure. Ask your healthcare provider how these risks apply to your child. Be sure to discuss any other questions or concerns that you may have.