Central Line Inserted Central Catheter
Central Line Inserted Central Catheter
- Peripherally inserted central catheter (PICC line)—The catheter is threaded through a vein in the arm until it reaches the larger vein close to the heart.
- Non-tunneled central catheter—It is inserted in a large vein in the neck or leg; the tube end is outside of the skin.
- Tunneled central catheter—It is inserted in the neck vein and “tunneled” under the skin. The end of the catheter is sticking out from under the skin, usually below the collarbone.
- Port catheter—It is inserted in a shoulder or neck vein. The port is under the skin, and the catheter is tunneled into the central vein. The port is accessed by putting a needle through the skin directly into the port.
|Veins in the Arm|
|A peripherally inserted central catheter is threaded through a vein in the arm.|
|Copyright © Nucleus Medical Media, Inc.|
Reasons for Procedure
- Long-term medicine or fluids
- Nutrition, but cannot get it through the digestive system
- Repeated blood draws
- Blood transfusions
- IV medicine when arm veins are difficult to access
- Bloodstream infection —occurs when bacteria enters the bloodstream through or around the central line
- Collapsed lung
- Heart arrhythmias (changes in the way your heart beats)
- Nerve injury
- An air bubble or part of the catheter blocks a blood vessel, causing chest pain, shortness of breath, dizziness, and rapid heart beat
- Blood clots in the vein or on the catheter, potentially blocking the vein
- Veins that are difficult to reach
- Blood clots
- Broken bones
- Poor blood circulation
- Clotting or bleeding tendencies
What to Expect
Prior to Procedure
At your appointment before the procedure:
- You may have a blood draw to check how well your blood clots.
- Your doctor may ask if you have any allergies.
- Arrange for a ride home after the procedure.
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Anti-inflammatory drugs (eg, aspirin )
- Blood thinners, like warfarin (Coumadin)
- Clopidogrel (Plavix)
- If you think you may be pregnant, tell your doctor before the procedure.
Description of the Procedure
- Carefully choose a safe site to insert the catheter.
- Thoroughly wash their hands or use a hand sanitizer.
- Wear surgical gowns, masks, gloves, and hair coverings.
- Clean your skin with an antiseptic.
- Place a sterile sheet over you.
- Give you an anesthetic.
- Make a small incision.
- Use an x-ray or ultrasound to guide a wire into the vein.
- Before inserting the catheter, cut it to the correct length. Flush the catheter with saline (salt water).
- Insert the catheter using the guide wire. Then, remove the wire.
- Use sutures or tape to secure the catheter line. Place caps on the end of the catheter.
- Cover the insertion site with a bandage. Write the date of the insertion on or near the bandage.
Immediately After Procedure
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Do an x-ray to make sure your catheter is in the correct position.
- Continue to check the insertion site for bleeding.
- Give you medicines, fluids, or nutrition through the catheter.
- Flush catheter ports to prevent blood clots.
Take steps to reduce your risk of infection by:
- Thoroughly washing their hands and wearing gloves before touching the catheter or changing the bandage
- Using an antiseptic to clean the catheter opening
- Taking precautions when handling medicine, fluid, or nutrition that will be delivered through the catheter
- Watching you closely for signs of infections—These signs include fever, chills, and problems at the insertion site (eg, redness, swelling, drainage).
- Not allowing visitors in your hospital room when the bandage is being changed
- Keeping the catheter in place only as long as it is needed
- Ask the staff to take every precaution to prevent an infection.
- Tell the staff right away if the bandage needs to be changed or if the site is red or sore.
- Ask everyone entering your hospital room to wash their hands. Do not allow visitors to touch your catheter.
- Keep your insertion site clean, dry, and covered with a bandage. Follow your doctor's instructions for changing the bandage.
- Before touching the catheter, wash your hands or use a hand sanitizer. Wear gloves when touching the area.
- Ask your doctor about when it is safe to shower, bathe, or soak in water. If allowed by your doctor, cover the bandage with plastic when showering.
- Do not swim or bathe while your central line is in.
- Avoid lifting or any kind of activity that may loosen the central line.
- Do not allow anyone to touch the catheter or the tube.
- Check the insertion site daily for signs of infection (eg, redness, pain).
- Learn how to take care of your catheter.
- Flush the line with saline or heparin as directed.
- Take medicine as directed.
Call Your Doctor
- Signs of infection—fever and chills, redness or swelling at the insertion site
- Pain at the insertion site
- Drainage or leakage from the catheter
- Trouble flushing or inserting fluids into the catheter
- Catheter loosens or falls out
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Vascular Access Management http://picclinenursing.com/
The College of Family Physicians of Canada http://www.cfpc.ca/
Health Canada http://www.hc-sc.gc.ca/index-eng.php
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6/3/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
- Reviewer: Marcin Chwistek, MD
- Review Date: 11/2012 -
- Update Date: 11/30/2012 -