What is a central line?
A central line is a type of flexible, sterile tube that’s longer than a standard intravenous (IV) line. A doctor will place it into a vein that goes to your child’s heart, so they can give medications, fluids, or nutrition.
Most often, central lines are placed in patients who need IV therapy for an extended period, which can range from a few weeks to a few years. They are stable and secure, designed to support your child’s long-term medical needs.
What types of central lines are there?
There are three different types of central lines. Your doctor will perform a thorough analysis to determine which type of central IV line your child needs. Throughout this procedure, your child’s comfort is always top of mind. Regardless of the type of central line, our doctors can use a special type of numbing medication before inserting the needle to minimize the pain.
This line travels under the skin in your child’s chest and into a vein near their neck. Doctors normally recommend Hickman/Broviac catheters for children who need IV access for several months or years.
This line goes entirely under the skin of your child’s chest, and a thin tube connects the port to a vein in your child’s neck. To access the IV, your child’s doctor will insert a special small needle through their skin and into the port. Like Hickman/Broviac catheters, ports are also recommended for children who need IV access for several months or years
A specially trained nurse will place this type of central line in your child’s vein in their arm or leg. PICC lines are recommended for children who need IV access for a few weeks to months.
Why does my child need a central line?
When a child needs a central line, it’s because they need IV medications, nutrition, or fluids for an extended period. These lines enable doctors to administer those elements faster, and with less risk of damaging smaller veins.
Another benefit of a central line is that it minimizes the amount of sticking our patients must endure. For children who need routine or long-term intravenous care, it can be scary to need a new needle every time they need an IV started or their blood is drawn. A central line allows easier access with minimal discomfort.
How do I care for a central line?
The steps you will take to care for your child’s central line will be based on the type of line that their doctor places. Your care team will work with you to make sure you understand every step required to keep their line clean and effective.
In general, there are a few basic guidelines that you can follow to ensure the line stays in good shape.
- Keep the central line clean, dry, and safe.
- Keep the central line pinned safely to your child’s clothing.
- Position the central line so it will not get accidentally pulled out.
- Protect the central line from germs, dirt, and debris.
- Keep the central line away from the risk of direct injury, trauma, or stress.
- Cover the central line in a clean dressing that sticks to the surrounding skin.
- Replace all dressings immediately if they peel off or the skin underneath becomes wet.
Flushing the Line
To keep the central line clean and free of obstructions, you will also need to flush it regularly with fresh fluid. Your care team will walk you through the steps required to do so. We will clearly explain the type of fluid to use, as well as the amount to use and how often to flush it.
Changing the Dressing
The dressing that surrounds your child’s central IV line should always be kept clean. It’s important to refresh it regularly and change it promptly if you notice any signs of wear.
Treating a Broken Line
If your child’s central line begins to leak or break, do not try to repair it at home. Instead, take your child to the nearest emergency department. A broken line can allow room for germs and bacteria to enter your child’s bloodstream, which is a direct risk to their health and safety. By addressing this event as an emergency, you can help ensure prompt treatment, so your child does not get sick.
Caring for the Line at Home
Your child’s discharge plan will be specific to their individual situation. You will receive thorough instructions on how to properly care for your child and their central line before you leave the hospital. Your care team will explain the exact steps to follow, which will include:
Three to five days after their surgery, your child should be able to take a shower. After seven days, they can take a bath. If you need to bathe your child during their first week home, a sponge bath is permissible, though it’s important to keep their incisions clean and dry. Your care team will show you how to safeguard the central line area while bathing to keep it out of the water.
Your child can return to their normal diet when they arrive home. Follow your care team’s instructions on any special feeding requirements you will need to adhere to.
It might take some time for your child to return to their normal, pre-surgery activity level. This is normal as they adjust to life with their line. As they recover at home, they will steadily regain their strength.
Your child’s doctor will give you a prescription for pain management. If approved, they may also take acetaminophen (Tylenol®) or ibuprofen (Motrin®).
When to Call Your Care Team
Contact your doctor at any time if you have questions or concerns about how to care for your child’s central IV line. For any critical signs there may be an issue with the line, contact your doctor immediately. These signs may include:
- Redness, swelling, drainage, or tenderness at the site where the catheter enters the skin
- A temperature higher than 101 degrees Fahrenheit
- Difficulty flushing the central line
- Any type of pain or discomfort while administering medications or fluids through the line