Central Line Possible Problems
Children often go home with central lines, commonly called C-lines, and usually do not have any problems. You can help your child avoid problems with his/her central line. The following information tells you about possible problems, what to do and how to prevent them.
Your child should have an emergency kit with them at all times. The kit should have things that may be needed in case there was any damage to the central line or if the dressing came loose.
Infection
There are two types of infection that are possible:
Exit Site Infection:
This is an infection on the skin where the central line comes out of the body. Signs may include redness, drainage, pain, swelling and/or warmth.Blood Stream Infection:
This is an infection that is in the blood. Signs may include fever, chills, shaking, drowsiness and/or dizziness.
What to do for Signs of Infection
Take your child’s temperature daily and check the central line dressing at least daily. Call your doctor if your child has a fever or any signs of infection.
How to Prevent Infection
- Wash your hands before doing any central line care.
- Always keep a clean and dry dressing over the central line site. If the dressing is not sticking, change the dressing if you have been taught how to do so, or call the Home Care nurse.
- Follow the instructions for cleaning the cap and the use of sterile equipment.
- Make sure the central line dressing and cap changes are done weekly.
Blockage or Clotted Central Line
Blockage can be caused by blood clotting inside the central line or by certain solutions mixing inside the central line. You would know there is a blockage if:
- The central line becomes very hard to flush or you are not able to flush it at all
- If an IV solution will not go in through the central line
What to do for Signs of a Blockage
- Make sure that the central line clamp is open and that the central line is not kinked or bent when you flush
- Be careful not to push hard to flush, as this could cause a hole or tear in the central line
- For a double lumen central line, check both lumens as it is possible for only one lumen to be blocked
Call your doctor or your Home Care nurse. Your child may need to be brought to the hospital to have a medication put into the central line to remove or dissolve the blockage.
How to Prevent a Blockage
- Flush the central line once every 24 hours
- Keep the clamp closed whenever the central line is not being used
- If blood ever backs up into the central line, scrub the cap and flush
- Keep the central line in an upright position to help prevent blood backing up into it
Pulls or Tugs on the Central Line
A pull or tug on the central line could cause it to be pulled out part of the way or all the way. It could also cause damage to the central line.
What to do for a Pull or Tug on the Central Line
- Look at the dressing. If it is loose, or there is any bleeding, change the dressing to check central line. If you have not been trained to change the dressing, call your Home Care nurse or doctor.
- If the central line has been pulled out, call your Home Care nurse or doctor. Do not flush or use the central line.
- For any bleeding, apply pressure to the site with gauze to stop the bleeding.
- If there is a large amount of bleeding or your child is having any trouble breathing call 911 or your local emergency number right away.
How to Prevent a Pull or Tug
- Secure the central line to your child’s body with a securement device
- For younger children, use one piece outfits to cover the central line
- Take extra care when removing clothing to avoid a pull or tug
- When tubing is connected to your child’s central line, keep the tubing close to his/her body
Damage to the Central Line
It is possible to get a hole or tear in the central line. You may be able to see the hole or tear. There could also be damage that you cannot see.
Signs of Damage
- Wetness under the central line dressing or along the tubing
- An area of bulging on the central line
- A pink area on the central line that does not clear with flushing
- Puffiness or swelling on the skin near the central line
What to do for a Damaged Central Line
- Clamp the Central line between the hole or tear and your child. Next, place a piece of tape over the hole or tear. Then scrub and flush the central line if you can.
- Call your Home Care nurse or doctor. The central line can be repaired and this would be done at the hospital.
How to Prevent a Damaged Central Line
- Always keep scissors and all sharp objects away from the central line
- If the central line is hard to flush, do not try to force it
- Secure and protect the central line
Air in the Bloodstream
This is very rare, however, it could happen if the cap were to come off the end of a central line that is not clamped. It could also happen if there was a cut or tear in the central line. It takes a large amount of air in the bloodstream to cause a problem. If air gets into the bloodstream, your child could have trouble breathing, chest pain, and/or coughing.
What to do for Air in the Bloodstream
- Clamp the central line as close to your child as possible
- Have your child lie on his/her left side
- Call 911 if there are breathing problems or chest pains
- Call your Home Care nurse or doctor
How to Prevent Air from Getting into the Bloodstream
- Make sure cap stays in place at end of central line
- Keep scissors and sharp objects away from central line to avoid accidental cuts
- Secure and protect the central line as you were taught
Rev. 3/09
