Central venous line - care of

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 named nurse or doctor.

What is a central venous line?

The CVC (central venous catheter) is a soft flexible hollow tube that is placed into a large vein, most usually in your neck. Occasionally it may be placed in a vein in your groin. It is designed to stay in your body for 7-10 days.

It can be used to give you fluids, blood products, intravenous medications and take blood samples.

The line is maintained in place by stitches which will be removed at the same time as the line, when it is no longer needed. There is a plastic clamp on the line which must be closed when it is not in use. At the end of the line there is a cap or bung which will need to be changed weekly.

Caring for your central venous line

Keep the dressing in place at all times: A transparent dressing will cover the exit site. This dressing will need to be changed at least weekly but sooner if it is starting to peel off, or if the wound looks mucky or is bleeding. This will be changed by ward Nurses. During dressing changes and when the line is being connected/disconnected, avoid breathing or coughing over it, to reduce the risk of germs entering the bloodstream.

Avoid sharp objects near your line – Shaving around the line if required can be done with extreme caution by your nurse.

Avoid getting the dressing wet (avoid deep baths/swimming). Take care to keep it dry even when showering. Your hair should be washed over a sink to avoid getting the dressing wet.

Never open the clamps or remove the end caps from the lumens. These prevent air and germs from entering the blood stream

Avoid pulling on the catheter- This can be painful and if the line gets dislodged, you could bleed and your treatment could be delayed. Vigorous activity should also be avoided.

Using your line

The end of the line must be thoroughly cleaned with an antiseptic (chlorhexidine) wipe before it is used, and the bungs should be changed at least weekly. Anyone using your line should be trained and should be using a special technique called an ‘aseptic non-touch technique.’ They should not be using a syringe smaller than a 10 mL syringe. Each lumen of your line needs flushing after use to prevent it from becoming blocked.

Will it be painful afterwards?

Once the local anaesthetic wears off you may find the procedure site tender and uncomfortable – this is normal and should only last a day or two. It is fine to take simple painkillers such as paracetamol if required.

Some people get some pins and needles in their arm, this should not last more than 24 hours.

Can I have a bath/shower?

You can shower with a line in, or sit in a bath, but the line MUST not be submerged. Do not apply any creams or lotions to the insertion site or the line. The line, insertion site or bungs must not be submerged because of the risk of infection.

What happens if something is wrong?

Infection

If you notice redness around the line or a discharge from the entry site or if you have a temperature above 37.5 degrees, fever, chills or feel 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 blood clot.

Blocked line

If the line becomes blocked, then it may be difficult to aspirate blood or to inject through the line. In most cases, the line should not be used until the problem has been dealt with. Special clot-busting drugs can usually help.

Rare complications

Rarely, the line can irritate the heart and cause abnormal heart rhythms or cause fluid to build up in the sac around the heart. If you feel any palpitations, light-headedness, dizziness or shortness of breath it is important to seek immediate medical advice.

Occasionally, the line can become dislodged. If you notice that the line is further out than normal, then seek immediate medical advice.

You should not feel pain when the line is being used – if you do, then please report this.

Other complications that may occur when the line is in place

Line falls out

In the unlikely event that this occurs, you should immediately apply pressure to the site to stop any bleeding. SEEK FOR HELP (ask your room mates to contact either the doctor or the nurse ASAP if you are unable to do that).

Bleeding from around exit site

Apply pressure to exit site, and contact your nurse/doctor as soon as you can

Line clamps break/tubing becomes cut/punctured

Inform your nurse as soon as you can as she will clamp the line to prevent damage caused by bleeding and by air entering the bloodstream.

Clamping the line ASAP helps to prevent damage caused by air entering the bloodstream.

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

Prior the removal you will need to lay flat with the head of your bed tilted down and your legs raised, as this prevents air entering in your bloodstream. Your nurse will put pressure on the site to prevent bleeding and an occlusive dressing will be applied. The dressing should remain in situ for 48 hours.

Privacy & dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.