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Hello. You or someone you are caring for is going home with a central line. You have already
been provided with written information, and now we will be reviewing the general care
for central lines.
This includes: Infection prevention, dressing and cap changes, flushing the central line,
activities you can and cannot do, potential complications, when to call for help, or how
to use resources and contact your healthcare providers.
A nurse will make sure that you know exactly how to care for your central line and what
supplies are needed before you go home. Be sure to ask questions if there is anything
you do not clearly understand. Often a home care nurse will come to your
home to care for your central line or to continue teaching you how to care for your line.
Let's start with the most important aspect of line care, infection prevention. Your health
care providers have already talked to you about the potential risk of getting an infection
in your blood through your central line. Therefore it is very important to make sure that you
and any one who uses your central line follows infection prevention care.
The most important step in infection prevention is hand hygiene. Anyone who uses your catheter
must first wash their hands. Also, any time someone uses your line, they need to scrub
the cap for 15 seconds with an alcohol wipe. These are two of the most important steps;
there are other steps to prevent an infection that we will review.
It is important to avoid activities that put you at risk for getting the dressing wet,
dirty or pulled off. The dressing on your central line needs to
be changed every 7 days or sooner if it becomes wet or dirty.
If you need to shower, make sure the dressing is covered so it does not get wet. There are
a variety of products available for this; sometimes plain plastic wrap with tape works
well. Be sure to avoid spraying water directly on the area as it may not be perfectly sealed.
If your central line dressing does get wet, it will need to be changed at that time.
When you have a central line you can not go swimming. There is one exception- this is
if you have an implanted port and it is not accessed with a needle. Speak to your health
care provider if you have any questions about swimming with your catheter.
The central line should be taped under your clothing and always above the waist. Caregivers
of small children should make sure that the child's central line is not in contact with
the diaper.
If your dressing is loose, or dirty, or after seven days, your dressing should be changed.
It can be changed by your healthcare provider. If you have been taught to change it by your
nurse or doctor, you may change it as well. It may take several times practicing with
the nurse before you can change your dressing alone.
Your central line needs to be flushed after each time it is used for a medication, infusion
or blood draw. When your tunneled central line is not being used it needs to be flushed
every day. When implanted ports are not being used, they need to be flushed every month.
The access caps on the line need to be changed every 4 days.
While a central line is necessary for your care, it can increase your risk for an infection.
To minimize that risk, we will use a vein in your arm or hand to draw blood whenever
possible. This is the safest way to prevent infection. Each time the central line is used
there is a chance for infection to take place.
It is important not to get air into your central line. Always make sure that the clamps on
your central line are closed and that the access caps are on tight. You will be taught
what to do if a cap falls off. Also, always keep a special clamp with you in case the
central line breaks. The nurse will give the clamp to you before you go home.
Your physician or nurse will tell you what types of physical activities are OK for you
to resume. Contact sports are usually prohibited because of the potential for a blow to the
chest, or the line accidently getting pulled out. As we mentioned earlier, you should not
swim with a central line, unless it is an implanted port that is not currently accessed.
Now, let's go over some possible problems you might see at home. The signs of infection
and problems are similar for all types of central lines. If you have any sign of infection
or central line problem, call your doctor immediately.
Signs of infection can include redness, tenderness, warmth or drainage around the catheter site,
a fever of 100.5 or greater or chills. Other signs of a problem can be swelling of the
face, neck, chest or arm on the same side as your central line, the inability to flush
or a resistance when flushing the central line and leakage of blood or fluid at the
catheter site or the cap.
There are also some complications that require you to call for immediate help. Although these
do not happen often, it is important for you to know about them and whom to call.
If you develop sudden chest, neck or shoulder pain, coughing or difficulty breathing, make
sure your central line is clamped. Lie on your left side with your head down and have
your care provider call 911. This may be an indication that there is a clot or air in
your lung.
Another complication that needs immediate attention is if your catheter becomes accidently
removed, however, this does not happen often. If it does, you need to apply pressure to
the site with a gauze pad or clean wash cloth. Call your doctor immediately.
If your catheter has a hole or break in it, use the special clamp you were given. Clamp
your line between the hole and where the catheter exits your body. Do not use the line and call
your doctor. It is important for you to be careful with
your central line, to protect it and to avoid activities that could possibly pull or break
your line.
We have just given you a lot of information. And you will receive written instructions
before you leave the hospital. You will also receive a "Pass Book" that tells you when
and whom to call. Please call the doctor listed anytime you have questions about your central
line. The "Passbook" also has important instructions for other healthcare providers. Be sure to
bring it with you anytime you go to your doctor's appointment, or if you go to the hospital.
Remember, your health care team is always available to answer any questions you may
have while you are home with your central line. If you have any questions about caring
for your line, or the content of this video, please ask your nurse or doctor. Thank you.