With a central venous catheter, you basically have a direct line from the outside world right to your heart. That’s great for getting treatment, but it means you have to manage it very carefully. So the short answer for how to care for it is: exactly how your nurse tells you to.
When you get a CVC, a nurse or someone else on your health team shows you what you’ll need to do with very detailed, step-by-step instructions. If you’re not up to doing it yourself, your nurse can teach a friend, partner, or relative who can help. Or, you might get a home-care nurse to do it for you.
You’ll also need a lot of supplies, such as cleaning products, new dressings, and catheter parts. Your nurse will set you up with a company that specializes in this kind of work and gives or sends you supplies as you need them.
Does the Type of CVC Make a Difference?
Yes. There are several kinds of CVCs. Here are three of the most common:
- PICC lines go into your upper arm and have one or more tails, called lumens, that hang out. That’s where the medicine goes in.
- Ports go entirely under your skin, usually in your chest. Your doctor uses a needle to give you medicine.
- Tunneled CVCs also usually go into your chest, but like PICC lines, they have lumens for giving you medicine.
Since they both have lumens, care for PICC lines and tunneled CVCs is very similar. Ports don’t require as much care since they’re totally under your skin.
Mainly, you’ll do two things to care for your CVC:
- Flush it to make sure it doesn’t get clogged.
- Change the dressing and catheter parts -- you only do this for PICC lines and tunneled CVCs, not for ports.
To make care a little easier:
- Choose a time when you won’t feel rushed and no one will bother you.
- Gather your supplies before you start. This means everything from soap and alcohol pads to written directions.
- Call your doctor if you have any questions, even if they seem minor.
Flushing Your Catheter
When they’re not in regular use, you typically need to flush:
- Ports once every 4 weeks
- Tunneled CVCs and PICC lines once a week
To flush your catheter, you’ll follow a very clean process to inject it with one or both of these fluids:
- Saline, a specific mix of salt and water
- Heparin, a drug that prevents blood clots from forming and clogging your catheter
If the saline or heparin won’t go in, don’t force it. First, make sure your clamp isn’t on -- clamps may be used on tunneled CVCs and PICCs to keep the line closed when not in use. Then, check for bends or kinks in the tube. If you still have problems, call your doctor.
Change the Dressing and Catheter Parts
With PICC lines and tunneled CVCs, you typically change the dressing and catheter parts -- such as connectors and caps -- once a week. This helps keep everything clean. You’ll get supplies such as alcohol pads, gloves, and a cleaner such as ChloraPrep to help.
Here are a few tips to keep in mind:
- Change everything at the same time so you don’t miss anything.
- When you remove the dressing, look around the area where the catheter goes in for redness, swelling, or any fluid coming out. Call your doctor if you notice anything.
- Don’t change your dressing or catheter parts in the bathroom after a shower. Use a dry, clean, flat surface.
Tips to Avoid Problems
You should clamp lumens when they’re not in use, but do it in different places so you don’t wear down one area of the tube. Here are some other tips:
- Always wash your hands before touching your CVC.
- Don’t use scissors, safety pins, or other sharp objects near your catheter.
- Keep the dressing clean and dry.
- Make sure to have extra supplies on hand in case you need them.
- Tape the tube to your body so it doesn’t get tugged out of place.
When Would I Call My Doctor?
With a CVC, you have a higher chance of getting an infection. You can also get a blood clot that forms around the catheter. Call your doctor if you have any of these symptoms:
- Aches, chills, or other flu-like symptoms
- Dizziness or feel lightheaded
- Fever over 100.4 F
- Redness, swelling, or fluids draining around where the catheter comes out of your body
- Swelling, tenderness, or redness in your hands, fingers, arm, or neck
- Throwing up or feeling like you might
- Tightness in your chest or shortness of breath
You may also run into problems with the catheter itself. Call your doctor if you have any of these issues:
- There’s a break or leak in your catheter.
- You can’t flush it.
- Your catheter gets pulled out of place.
- A connector falls off.