Central Line Catheter Patient Information

A central line catheter is a very long intravenous line (I.V.) The Broviac, Hickman, and Hohn are different kinds of central lines. They are a long, thin, flexible tubes or catheters. The catheter is put in Your arm, neck, groin, or chest through the skin. It goes into a large blood vessel that leads to your heart. It allows for drugs used to treat infections, pain, cancer, nutrition, blood products, or fluids to be given.

Your catheter may have 1, 2, or 3 tips coming out of the skin to be able to give more fluid, drugs or liquid food. The risk of germs entering the body is increased from having a central line.

With a central line catheter, you will not need to have as many needle sticks. The line can be used to draw blood. These catheters can stay in place for weeks or months. Some may have it for years.

What care is needed at hospital and/or home?

• Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
• The staff will explain how to take care of the central line and bandage at home. Be sure to ask any questions you have about the line and taking care of it. You may need help from a friend or family member.
• Wash your hands with soap and water for at least 30 seconds before touching your bandage or central line. Do not let anyone touch your bandages or central line with dirty hands.
• You may wear sterile gloves if you need to touch the area.
• Ask your doctor how often you should change the dressing on your central line. Learn how to put on a new dressing.
• You will flush the central line with saline at regular times each day. Be sure to scrub the caps with an alcohol pad for 15 seconds before attaching the syringe. Do not let air get into the central line.
• Make sure that the caps of the central line are closed at all times. Change the caps when you change your bandage. Make sure you know exactly how to change the bandage and caps before you go home.
• Ask your doctor when it is safe to bathe, shower, and soak in water. Keep the bandages covered so they do not get wet while you are washing.
• Do not try to remove the central line by yourself or have anyone else pull on it. It must be taken out by specially-trained staff.
• Keep sharp objects away from your catheter.
• Avoid wearing clothes that could pull or bend the line.

What follow-up care is needed?

Your doctor will remove the catheter when your treatments are finished. Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.

What drugs may be needed?

The doctor may order drugs to:

• Fight an infection
• Treat your condition
• Prevent blood clots
• Treat cancer
• Give fluids or blood products
• Give nutrition

Will physical activity be limited?

You may have to limit your activity. Ask your doctor about the right amount of activity for you.

What problems could happen?

• Infection
• Bleeding from the skin or end of the catheter
• Blood clots in your vein or at the end of the catheter that can cause a blockage
• Break or crack in the catheter
• Leakage of drugs outside the vein, under the skin or fat tissues
• Air in the blood or air embolism
• Abnormal heartbeat
• Collapsed lung
• Catheter shifts out of place

When do I need to inform a doctor or a nurse?

• Signs of infection. These include a fever of 100.4˚F (38˚C) or higher, chills.
• Redness, yellowish drainage, warmth, stinging, or pain at the catheter site
• Problems with the catheter like:
  • Catheter falls out all the way or part of the way
  • Breaks, cracks, or leaks in the catheter
  • Not able to get the drugs or flush solution through the catheter
  • Not able to get a blood return from your catheter
  • You have any concerns about your catheter
• Sudden shortness of breath or chest pain
• Swelling on the face, neck, or chest on the side of the line
• Swelling or bulging veins around the catheter site
• You are not feeling better in 2 to 3 days or you are feeling worse

Teach Back: Helping you understand

The Teach Back Method helps you understand the information we are giving you. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these:

• I can tell you about my condition.
• I can tell you what I should do before I touch my central line or its bandage.
• I can tell you what I will do if I have redness or drainage from the catheter site.

Peripherally-Inserted Central Catheter Patient Information

About this topic

A peripherally-inserted central catheter is often called a PICC. It is a long, thin, flexible intravenous (I.V.) line or catheter. The catheter is placed into a small vein in your upper arm. It is moved forward until it is in a larger vein near your heart. An x-ray is done to make sure the tip of the PICC line is in the right place before it can be used. PICC lines are used:

• If you need to have drugs or fluids for a few weeks or months
• When drugs need to be given through an I.V and the veins in your arm are very hard to find
• To draw blood for tests

What care is needed at hospital and/or home?

• Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
• Keep the PICC covered at all times with the bandage. Keep the bandage clean and dry.
• You may have some soreness, bruising, or small amount of bleeding where the PICC was put in.
• Try putting a warm cloth over the area for 20 minutes. Do this about every 2 hours for the first day. The warm cloth should go on top of the bandage.
• The staff will explain how to take care of the PICC and bandage at home. Be sure to ask any Questions you have about the PICC and taking care of it. You may need help from a friend or family member to take care of the PICC.
  • Wash your hands with soap and water at least 30 seconds before touching your bandage or PICC.
  • Do not let anyone touch your bandages or PICC if their hands are dirty.
  • You may wear sterile gloves if you need to touch the area.
  • You will flush the PICC with saline at regular times each day. Be sure to scrub the caps with an alcohol pad for 15 seconds before attaching the syringe. Do not let air get into the PICC.
  • Make sure that the caps of the PICC are closed at all times. Change the caps when you change your bandage. Make sure you know how to change the bandage and caps before you go home.
  • Ask your doctor when it is safe to bathe, shower, or soak in water. Keep the bandages covered so they do not get wet while you are washing.
  • Do not try to remove the PICC by yourself or have anyone else pull on it. It must be taken out by specially-trained staff.

What follow-up care is needed?

• Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
• Your doctor will tell you when you no longer need the PICC for treatment.
• Taking out a PICC is painless. This is done by specially-trained staff and takes only a few, minutes.

What drugs may be needed?

The doctor may order drugs to:

• Fight an infection
• Treat your health problem
• Prevent blood clots

Will physical activity be limited?

You may have to limit your activity. Ask your doctor about the right amount of activity for you.

What problems could happen?

• Redness swelling, pain or drainage from the insertion site. This might mean the insertion site is infected.
• Pain up or down your arm where the PICC is. This is a sign that the vein is sore or irritated.
• The PICC might get infected on the inside of your body. If this happens, the PICC might have to be taken out or you might need a new drug.
• Swelling and pain in the arm where the PICC was put in. This might mean there is a blood clot in your arm.
• Bleeding that won’t stop from where the PICC was put in.
• A break or leak in the PICC.
• Leakage of drugs under the skin.
• The tip of the PICC moves out of place. The PICC may need to be taken out or repositioned.

When do I need inform a doctor or a nurse?

• Signs of infection. These include a fever of 100.4˚F (38˚C) or higher, chills.
• Sudden shortness of breath or a sudden onset of chest pain could be a sign that a blood clot has traveled to your lungs. Go to the ER right away.
• Signs of infection where PICC was put in. These include swelling, redness, warmth around the site, too much pain when touched, yellowish or greenish or bloody discharge, foul smell coming from the site.
• Not able to flush the PICC or it is very head to flush the PICC
• Nurses are not able to draw blood from the PICC
• PICC breaks, Falls out, or comes out part of the way
• You lose the caps to the PICC line

Teach Back: Helping you understand

The Teach Back Method helps you understand the information we are giving you. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these:

• I can tell you about my procedure.
• I can tell you what I should do before I touch my PICC or its bandage
• I can tell you what I will do if I have redness or drainage from my PICC site.