Central Line (Central Venous Catheter)

What is a central line?

A central line, also known as a central venous catheter (CVC), is a thin, long, flexible tube. The line passes through an opening in the skin and into a vein. The central line then travels through the vein until it reaches a spot just near or inside the heart.

The other end of the line extends outside of the body. The part on the outside of the body has a connector. The connector helps keep the line from leaking and helps keep germs out of the body.

The care team uses the central line connector to give:

• Medicines
• Parenteral nutrition
• Blood products
• Fluids

The care team can also use the line to collect blood samples for tests, such as a complete blood count and blood chemistry studies.

Benefits of a central line

• Your child will get fewer needle sticks for medicines, fluids, nutrition, blood products, or blood samples. Your child may still get needle sticks because some blood tests must come directly from a vein.
• Trained caregivers can use the line at home as instructed by the care team.
• The line can stay in place for months or longer.
• There is less irritation to the blood vessels from medicine and treatments.
• Caregivers may use the line to give medicines or nutrition with a syringe or IV bag.
• Care providers can give more than one medicine at a time with some types of lines.

The care team will remove your child’s line when it is no longer needed.

Types of central lines

Placement of a central line

A child may get a central line if they are seriously ill and need treatment for a long time. Your care team will tell you why your child needs a central line. Before line placement, the doctor may ask that your child follow NPO (nothing by mouth) instructions to limit food and drink. Your child must follow these instructions if asked to do so.

Your child might be awake or asleep (sedated) for the procedure. If your child will be awake, the care team will numb the skin first to prevent pain. Some patients may get general anesthesia to help them sleep during the procedure.

Anesthesia and surgical procedures always have risks. Your care team will tell you the risks and benefits of the surgery and anesthesia. They will also explain the risks and benefits of having a central line.

What to expect after central line placement

• If your child has anesthesia, they may sleep for about 1 hour.
• Your child may feel sore or stiff near the placement site.
• There may be some bruising or drainage.
• Your child may feel something pulling on the outside of their skin.

It may take several days for your child to feel comfortable with their line. Let your care team know about any pain or discomfort your child feels.

How to care for a central line

If your child is going home with the central line, your care team will teach you how to care for it. It is best if several family caregivers get line care training. Ask your care team about anything you do not understand.

Your child should not do activities that could damage the line, such as contact sports and rough play. They must not swim or get the site wet, as this can increase the risk for infection. Ask your care team what your child can and cannot do.

Watch for problems from a central line. This includes infections, blood clots, and movement of the line. Some infections, such as a central line-associated bloodstream infection (CLABSI) can be life threatening.

Tips to prevent central line infection

• Always wash your hands before caring for the central line.
• Practice good oral care to reduce mouth bacteria, including brushing teeth twice a day.
• Bathe and change your child’s clothing every 24 hours.
• Change your child’s bed linens once a week, or more often if they are soiled.
  
• Keep the dressing clean, dry, and secure.
• Change the dressing as directed by the care team.
  

Watch for signs of infection, and call your doctor right away if you have concerns.

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