It is rare for children to have problems from central venous line placement surgery. But all anesthesia and surgery have risks. Some complications of central line placement may include:
Injury to a blood vessel
Lung injury
Blood clots
Heartbeat that is not regular
Nerve injury
Infection
There are other possible complications when your child has a central venous line:
The vein may get swollen and irritated.
Your child may get an infection in or around the line.
The catheter could get blocked.
The catheter may move out of place.Blood clots may form in the catheter or in the vein.
The care team will talk with you about these risks and how to prevent them. They will treat problems if they happen.
The sooner you report problems, the better. Ask your health care team if you have questions or concerns.
Central line–associated bloodstream infection (CLABSI)
Bacteria (germs) may cause a blood infection if your child has a line. This type of infection is known as a central line–associated bloodstream infection (CLABSI). Bacteria can live on:
Hands
Skin
Connectors
Other items used for patient care and daily activities
Bacteria can enter the body different ways. They may come through a cut in the skin where the line enters the body or through the line itself.
This x-ray shows a central line on the left side of the picture. Extreme care must be taken to avoid getting bacteria in the catheter or around the spot where it enters the skin. In the photo, you can see that the central line goes under the skin and enters the heart. Any bacteria in the catheter can easily travel down the central line into the heart, leading to a CLABSI.
Central venous line infection prevention
Your care team will show you how to take care of your child's central venous line. You will practice with the team while your child is in the hospital.
It is normal to be afraid when you start learning. You will get more comfortable doing this with time. Line care will become part of your routine.
Carefully follow all the steps you learn in training so that you do not spread germs.
Only trained people should do line care.
Follow the care steps exactly as the team taught you.
Always wash your hands or use hand sanitizer before starting line care. Handwashing helps prevent infection.
Keep the dressing clean, dry, and stuck to the skin.
If the dressing gets loose, wet, or dirty, call your care team so it can be changed right away.
Follow your care team’s instructions on how to keep the dressing dry for a bath or shower.
Do not put a dressing under water. No swimming.
Keep the line secure so it does not move.
Do not let the tube from the line hang in the diaper area. where there are more germs.
If your child may drool or vomit, protect the dressing with a bib or other item worn on the outside of clothing .
Never use scissors, hemostats, or other sharp objects near the line tubing.
Watch your child carefully for infection. If you delay getting treatment for your child, the infection can get worse. It can even be life-threatening. If you notice fever and signs of infection, call your care team right away. They can check your child for infection and provide treatment if needed.
Wash your hands by scrubbing with soap and water for 20 seconds. Turn off the faucet with a clean towel. This will stop germs from the faucet from getting onto your hands.
Infection prevention
Clean your hands for 20 seconds. You must wash your hands or use an alcohol-based hand sanitizer. Rub your hands, your fingertips, and the back of your hands. Dry your hands well after use.
Clean your hands if you:
Enter and leave your child’s room
Use the bathroom
Change your child’s diapers
Touch objects
Clean your home
Sneeze, cough, or blow your nose
Touch body fluids such as blood or urine
Touch pets
Eat (clean hands before, too)
Feed your child (clean hands before, too)
Come inside from outside
Avoid others who are sick.
Bathe and change your child's clothing every 24 hours.
Keep your child's bedding clean. Change bedding weekly, or right away if it gets dirty.
Practice good oral care to reduce mouth bacteria, including brushing teeth twice a day.
Put lip balm on your child's lips to keep germs from entering through cracked lips.
Clean your home regularly to keep it germ-free.
Ask all visitors to wash their hands or use an alcohol-based hand sanitizer before they enter and exit your child’s room.
Do not let visitors touch the line.
Watch for signs of infection
Watch your child carefully for signs of infection. Depending on your child’s age or other factors, they may not be able to tell you how they feel.
Look for symptoms and behavior changes. Contact your clinic right away if you notice changes. If you wait too long, germs will continue to grow, and the infection will be harder to treat.
High and low temperature
If you see signs of fever, contact your care team right away. Fever in patients can be different depending on the illness.
Fever in cancer patients and bone marrow transplant patients is usually 99.4°F (37.4°C).
Fever in other patients is typically 100.4°F (38.0°C).
Ask your doctor what your child’s fever number should be.
A lower body temperature can also signal problems. If your child’s body temperature is lower than 96.8°F (36°C), this is life-threatening. Call your child’s care team at once.
Other signs of infection
Watch for these other signs of infection even if your child does not have a fever. Contact your care team right away if you notice:
Pain
Redness, swelling, soreness, or warmth where the line comes out of the body
Pus, leaking fluid, or a foul smell where the line comes out of the body
Blisters, rash, or skin sores
Chills
Rapid heartbeat
Cough or fast breathing
Dizziness
Seizures
Drowsiness or hard to wake up
Nausea, vomiting
Sweaty skin
Irritated or crying without a good reason
Watch for a central line blockage (occlusion)
There might be a blockage in the line if it is hard to flush with a syringe. If it seems hard to flush, do not force it. Stop and contact your doctor.
Check the line for kinks that might stop liquids from going in.
Make sure the line is unclamped.
If your child has a pump attached to the line, it may not be working.
If the block is from a blood clot, your care team might give your child medicine to clear the blockage.
Contact your care team if you notice any signs of blockage.
Watch for signs of central line damage and movement
If your child has a central line, do not tug or pull on it. If your child has a port, do not put pressure on it. Keep the line secure.
The line may have moved if:
It seems blocked
The nurse cannot get a blood sample from it
It hurts or feels uncomfortable in your child's arm, shoulder, jaw, chest, or head when medicines or fluids go in
The tube that is outside of the body looks longer than usual
If you think that your child’s line has moved or looks longer, call your child’s care team or the Infusion Center.
You can use your “Central Line Urgent Care Kit” if the line is damaged or comes out.
If you see a crack, a hole, or a cut in the line:
Clamp the line above the hole.
Clean the damaged area with an alcohol pad.
Wrap the area with sterile gauze.
Use tape to hold the gauze in place.
Call your clinic.
If your child has a tunneled central line that comes out:
If possible, have your child lay flat on their back.
Find the insertion site (small scar near your child’s neck). Put pressure on it for 5 minutes.
Cover the place where the line comes out of your child’s body (exit site) with sterile gauze.
Use tape to hold the gauze in place.
Call your clinic.
Do not throw the line away. Save it and bring it with you to the hospital.
Watch for signs of blood clots
Blood clots stop blood flow to a part of the body. The symptoms of a blood clot can vary, depending on where the clot is.
Contact your child’s care team or the Infusion Center if you notice:
Shortness of breath
Pain, swelling, or redness near the line areas such as in the neck, shoulder, arm, or chest
Your child may need a procedure to place a PICC line, also called a peripherally inserted central catheter. A PICC line allows medicines, nutrition, blood products, and fluids to be given into a large vein. Learn about PICC lines and how to care for them.
A central line, also known as a central venous catheter, is a thin tube placed into a large vein that leads to the heart. Learn more about central lines.
A tunneled central line is a central venous catheter that is tunneled under the skin. A central line allows medicines, nutrition, blood products, and fluids to be given into a large vein.
