A central line may be placed because:

• You need to get medicines or fluids through an IV for a long period of time.

• You need nutrition but cannot eat or absorb nutrients.

• The veins in your hands or arms are difficult to use for IV access.

• You need a blood transfusion.

• You need chemotherapy or dialysis.

There are four main types of central lines:

• Peripherally inserted central catheter (PICC) line. This type is used for access of one week or longer. It can be used to draw blood and give fluids or medicines. A PICC looks like an IV tube, but it goes up the arm to the heart. It is usually inserted in the upper arm and taped in place on the arm.

• Tunneled central line. This type is used for long-term therapy and dialysis. It is placed in a large vein in the neck, chest, or groin. It is inserted through a small incision made over the vein, and then it is advanced to the heart. It is tunneled under the skin and brought out through a second incision.

• Non-tunneled central line. This type is used for short-term access, usually for a maximum of 7 days. It is often used in the emergency department. It is inserted in the neck, chest, or groin.

• Implanted port. This type is used for long-term therapy. It can stay in place longer than other types of central lines. It is normally inserted in the upper chest, but it can also be placed in the upper arm or the abdomen. It is inserted and removed with surgery, and it is accessed using a needle.

Generally, placement and use of a central line is safe. However, problems may occur, including:

• Infection.

• A blood clot that blocks the central line or forms in the vein and travels to the heart.

• Bleeding from the place where the central line was inserted.

• Developing a hole or crack within the central line. If this happens, the central line will need to be replaced.

• Central line failure.

• The catheter moving or coming out of place.

Medicines

General instructions

• Follow instructions from your health care provider about eating or drinking restrictions.

• Ask your health care provider:

  • How your procedure site will be marked.

  • What steps will be taken to help prevent infection. These steps may include:

    • Removing hair at the procedure site.

    • Washing skin with a germ-killing soap.

• Plan to have a responsible adult take you home from the hospital or clinic.

• If you will be going home right after the procedure, plan to have a responsible adult care for you for the time you are told. This is important.

The procedure will vary depending on the type of central line being placed. In general:

• An IV will be inserted into one of your veins.

• You will be given one or more of the following:

  • A medicine to help you relax (sedative).

  • A medicine to numb the area (local anesthetic).

• Your skin will be cleaned with a germ-killing (antiseptic) solution, and you may be covered with sterile drapes.

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored during the procedure.

• The central line catheter will be inserted into the vein and advanced to the correct spot. The health care provider may use X-ray equipment to help guide the catheter to the right place.

• A bandage (dressing) will be placed over the insertion area.

Flushing and cleaning the central line

• Follow instructions from your health care provider about flushing and cleaning the central line and the area around it.

• Only use sterile supplies to flush the central line. Use supplies from your health care provider, a pharmacy, or another source that is recommended by your health care provider.

• Before you flush the central line or clean the central line or the area around it:

  • Wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use alcohol-based hand sanitizer.

  • Clean the central line hub with rubbing alcohol. Unless directed otherwise by the manufacturer’s instructions, scrub using a twisting motion and rub for 10 to 15 seconds or for 30 twists. Be sure you scrub the top of the hub, not just the sides. Never reuse alcohol pads. Let the hub dry before use. Prevent it from touching anything while drying.

Caring for the incision or central line site

• Check your incision or central line site every day for signs of infection. Check for:

  • Redness, swelling, or pain.

  • Fluid or blood.

  • Warmth.

  • Pus or a bad smell.

• Keep the insertion site of your central line clean and dry at all times.

• Change your dressing only as told by your health care provider.

• Keep your dressing dry. If it gets wet, have it changed as soon as possible.

General instructions

• Follow instructions from your health care provider for the type of device that you have.

• Keep the tube clamped, unless it is being used.

• If the central line accidentally gets pulled on, make sure:

  • The dressing is okay.

  • There is no bleeding.

  • The line has not been pulled out.

• Do not use scissors or sharp objects near the tube.

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.

• Ask your health care provider what activities are safe for you. You may be restricted from lifting or making repetitive arm movements on the side of your central line.

• Take over-the-counter and prescription medicines only as told by your health care provider.

• Keep all follow-up visits. This is important.

Storage and disposal of supplies

• Keep your supplies in a clean, dry location.

• Throw away any used syringes in a disposal container that is meant for sharp items (sharps container). You can buy a sharps container from a pharmacy, or you can make one by using an empty hard plastic bottle with a cover.

• Place any used dressings or infusion bags into a plastic bag. Throw that bag in the trash.