- Peripherally inserted central catheter (PICC line)—The catheter is threaded through a vein in the arm until it reaches the larger vein close to the heart.
- Non-tunneled central catheter—It is inserted in a large vein in the neck or leg; the tube end is outside of the skin.
- Tunneled central catheter—It is inserted in the neck vein and tunneled under the skin. The end of the catheter is sticking out from under the skin, usually below the collarbone.
- Port catheter—It is inserted in a shoulder or neck vein. The port is under the skin, and the catheter is tunneled into the central vein. The port is accessed by putting a needle through the skin directly into the port.
|Veins in the Arm|
|A peripherally inserted central catheter is threaded through a vein in the arm.|
|Copyright © Nucleus Medical Media, Inc.|
Reasons for Procedure
- Long-term medication or fluids
- Nutrition, but cannot get it through the digestive system
- Repeated blood draws
- Blood transfusions
- IV medications when arm veins are difficult to access
- Bloodstream infection —occurs when bacteria enters the bloodstream through or around the central line
- Collapsed lung
- Heart arrhythmias —changes in the way your heart beats
- Nerve injury
- An air bubble or part of the catheter blocks a blood vessel, causing chest pain, shortness of breath, lightheadedness, and rapid heart beat
- Blood clots in the vein or on the catheter, potentially blocking the vein
- Blood clots in the lung
- Veins that are difficult to reach
- Broken bones
- Poor blood circulation
- Clotting or bleeding tendencies
- Chronic diseases
What to Expect
Prior to Procedure
At your appointment before the procedure:
- You may have a blood draw to check how well your blood clots.
- Your doctor may ask if you have any allergies.
- Arrange for a ride home after the procedure.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
- Anti-inflammatory drugs such as ibuprofen
- Blood thinners
- Anti-platelet medications
- If you think you may be pregnant, tell your doctor before the procedure.
Description of the Procedure
- Give you an anesthetic.
- Make a small incision.
- Use an x-ray or ultrasound to guide a wire into the vein.
- Before inserting the catheter, cut it to the correct length. Flush the catheter with salt water.
- Insert the catheter using the guide wire. Then, remove the wire.
- Use sutures or tape to secure the catheter line. Place caps on the end of the catheter.
- Cover the insertion site with a bandage. Write the date of the insertion on or near the bandage.
Immediately After Procedure
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Do an x-ray to make sure your catheter is in the correct position.
- Continue to check the insertion site for bleeding.
- Give you medications, fluids, or nutrition through the catheter.
- Flush catheter ports to prevent blood clots.
- Take steps to reduce your risk of infection.
- Ask the staff to take every precaution to prevent an infection.
- Tell the staff right away if the bandage needs to be changed or if the site is red or sore.
- Ask everyone entering your hospital room to wash their hands. Do not allow visitors to touch your catheter.
- Keep your insertion site clean, dry, and covered with a bandage. Follow your doctor's instructions for changing the bandage.
- Before touching the catheter, wash your hands or use a hand sanitizer. Wear gloves when touching the area.
- Ask your doctor about when it is safe to shower, bathe, or soak in water. If allowed by your doctor, cover the bandage with plastic when showering.
- Do not swim or bathe while your central line is in.
- Avoid lifting or any kind of activity that may loosen the central line.
- Do not allow anyone to touch the catheter or the tube.
- Check the insertion site daily for signs of infection, such as redness and pain.
- Learn how to take care of your catheter.
- Flush the line with saline or heparin as directed.
- Take medication as directed.
Call Your Doctor
- Signs of infection, including fever and chills, redness or swelling at the insertion site
- Pain at the insertion site
- Drainage or leakage from the catheter
- Trouble flushing or inserting fluids into the catheter
- Catheter loosens or falls out
American Cancer Society http://www.cancer.org
Centers for Disease Control and Prevention http://www.cdc.gov
The College of Family Physicians of Canada http://www.cfpc.ca
Health Canada http://www.hc-sc.gc.ca
Central venous catheter. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 25, 2013. Accessed August 8, 2013.
FAQs: Catheter-associated bloodstream infections. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov. Accessed August 8, 2013.
Vascular access procedures. Radiological Society of North America website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=vasc%5Faccess. Updated August 5, 2013. Accessed August 8, 2013.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
- Reviewer: Marcin Chwistek, MD; Michael Woods, MD
- Review Date: 08/2013 -
- Update Date: 05/11/2013 -