I first heard about the term central line when my son was a baby. Born early and with his failing health, he needed lots of fluids (drips) and sometimes blood to be delivered through his tiny little veins. At other times, he needed blood tests. This meant more pricking and prodding. He cried and wailed a lot when the need to either take or give him fluids increased. By the first 6 months of his life he had so many scars on his hands, feet and even his head.
That was when I got told that he needed a central line. My first thoughts were that he was going to be given a drink in the centre of his body. I consented to the procedure without batting an eyelid. All I could think of was how to lessen his suffering. It was carried out under general anaesthetic and it certainly improved his quality of life especially from a trauma point of view.
Well fast forward many years later, my son has had so many central lines done at different times. We have mostly had to remove them due to infection rather than age. One of such infections was nearly fatal. In our case, the central lines have become a permanent fixture because his medical needs are way higher than we all wish. He still needs fluids and samples collected from him on a fairly regular basis.
For a family new to the idea of having a central line, it will be useful to ask as many questions as possible before, during and after the process. Here are some questions I got answers to which you may find useful. Remember that these answers are based on my understanding of what the health professionals handling my son’s care have advised. In case you notice any contrary advice, kindly seek clarification with your child’s medical team in the first instance and always follow their advice. This is not a medical write up and should be used only as a guide to give you an idea of the whole central line shenanigan … So please, now that we have cleared that up and without any further ado, here they are!
- What is the central line? It is a tube made of soft plastic material. The tube is placed in the child’s chest until the end of the tube inside the child’s body is sitting close to the heart.
- Why does my child need a central line? From what I was told, it sits in a big vein close to the heart and makes life a lot easier for the child and medical practitioners in terms of giving or collecting fluids, blood, feeds and for carrying out necessary intervention as the need arises. It is also useful for collecting blood samples for tests. It is used for giving medicines that will otherwise be injected thereby reducing the direct trauma to the child. This is because only the tube will be used for access rather than pricking the child with needles.
- How long does it last? It depends on the type of central line you are given. At one point our son had a port-a-cath. It can last up to one year- sometimes more. Other central lines like Hickman lines and Groshong lines have their different life-spans so don’t forget to find out.
- Can my child swim? Once again it depends on the type you have. For a port-a-cath (like the one we have), the device sits under the skin. When in use it is accessed with a needle from outside the skin and stuck down with tape. During access it will not be safe to swim with. Once de-accessed, your child can swim because there will be nothing outside the skin. If it is a Hickman or Groshong line, you will have to check the suitability for swimming with your child’s doctor.
- How will the central line be inserted? It is usually done under general anaesthetic. As the child sleeps, the line is inserted and secured. The child will not feel it. The child may be sore for a few days afterwards. Like with any operation there are risks of infection, scarring, bleeding etc but all these will be properly discussed with you before you consent to the procedure.
- What happens to the skin around the central line? The skin will be regularly cared for. Some children (like my son) may find the tape securing the line to the skin irritating. Irritation can include soreness, itchiness, rashes and oozing. Report this as soon as you notice to the doctors and nurses caring for your child. A skin rescue protocol can be devised by the practitioners looking after your child to protect the skin. Aqueous Creams, steroid creams and other ointments can be used to soothe the skin regularly.
In general, central lines are medical devices that should not be taken lightly. You have to monitor your child. Make sure they do not get broken. An emergency kit should be provided in case this happens. You must ask for one before your child is discharged. Your doctor will explain fully what you have to do if such an emergency arises with the line. You will be given details about who to call and where to go in order to sort out your child’s device.
Proper hygiene is also required when handling central lines to avoid infection. You can check out the GOSH and Macmillian websites for more information. They use these lines regularly and have more resources that you may find useful. What are your experiences with them, good or bad? For those new to central lines, ask away and one of us here will point you in the right direction.
Thank you for reading.
Photo credit: Pixabay
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