Care of your tunnelled central line

Information for patients

This leaflet answers common questions about caring for your central venous catheter. If you would like any further information or have any particular worries, please do not hesitate to contact your specialist nurse or doctor.

What is a central venous catheter?

A central venous catheter is a soft, hollow tube that is placed into a large vein leading into the heart and comes out through a small opening in the chest area. This opening is called ‘exit site’. There is also an entry site either in your neck or under your collar bone. This is a small opening which is stitched with dissolvable stitches.

The catheter can be used to give you fluids, blood products, medicines and take blood samples.

There is a cuff on the line a few centimetres above where it enters the skin. This holds the line in position and helps prevent infection. There is a plastic clamp on the line which must be closed when the line is not in use. At the end of the line there is a cap.

Will I need to stay in hospital after my central venous catheter has been inserted?

Some patients will be admitted to hospital to start treatment as soon as the catheter is inserted, other patients will be discharged out into the community providing there are no complications.

Caring for your central venous catheter

Once the line has been placed it is important to keep it clean and dry .This includes the entry site, the exit site and the bungs of the line. A licenced glue is applied to the insertion and exit site at the time of insertion. A transparent dressing will cover the exit site while the stitch is still in place. If the wound appears clean and dry the line needs to be re dressed each week. If bleeding occurs and is bigger than a 5 pence piece the dressing will need to be changed as soon as possible.

At 7 days a chlorhexidine disc will be put around your catheter at the exit site. This stays in place for as long as you have stitches attached to your skin. It needs to be changed every 7 days when you have your dressing changes.

After about 3 or 4 weeks when the wound has healed the stitch needs to be removed by a nurse. A dressing will no longer be needed, but the line must remain looped and secured with tape.

Keeping the central line clear

Regular flushing of your line is necessary to prevent the line from becoming blocked. This should be done once a week. You may get this done at the hospital or district nurses will be contacted. This is arranged by your specialist nurse.

The end of the line must be cleaned with a chlorhexidine wipe before it is used.

No smaller than a 10 ml syringe must be used to put fluids in your line and each end must be flushed separately if you have more than one. The line should be “locked” with 2mls of Hepsal if it is not being used for more than 24 hours.

The bung should be changed each week. Remember to check daily that the bung is attached and the clamps are closed.

Please note: dressing changes, line flushes and bung changes are a sterile procedure. If you experience a cold and shivery feeling during or after your line flush contact your emergency numbers.

Living with your central venous catheter

Can I have a bath / shower?

You can shower with a line in. Try and keep the line as dry as possible. The line, exit site or bungs must not be submerged because of the risk of infection.

Can I lead a normal social life?

Having a central venous catheter should not interfere with your social life. Please talk to your specialist team before planning a trip abroad.

Can I play sports and swim?

Sports and exercise that include vigorous activity should be avoided because the catheter may become dislodged. Make sure the catheter is secure. Do not swim with the catheter in place because of the risk of infection.

What happens if something is wrong?

Infection

If you have a temperature above 37.5 degrees, fever, chills or feeling generally unwell it could mean that you have an infection.

Signs of a blood clot

Pain, swelling or discomfort in your neck or arm on the side of the catheter insertion could be signs of a clot .It is usual for the first couple of days following insertion to feel discomfort.

Contact your specialist teams immediately if you have any of the above symptoms.

What happens if the central venous catheter breaks?

If your line cracks or breaks, don’t worry. Clamp, pinch or tie your catheter immediately above the break. Cover with a dressing and contact your specialist teams as soon as possible. You will have to return to hospital to get it repaired or replaced.

How is the central venous catheter removed when it is no longer needed?

The catheter is removed by making a small cut and releasing the cuff which holds the line in place. A local anaesthetic is given to numb the area around the cuff before it is removed. Dissolvable stitches are used to close the wound. It will be covered by a dressing which is removed after a couple of days. You will need to have an appointment made by your specialist team and come back into hospital. You will need to have blood samples taken and stop blood thinning medication before removal. This will be arranged by your specialist team.

Privacy and dignity

We are committed to treating all patients with privacy and dignity in a safe, clean and comfortable environment. This means, with a few exceptions, we will care for you in same sex bays in wards with separate sanitary facilities for men and women.