What is tunneled catheter placement?

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Tunneled catheter placement: Overview

A tunneled catheter is a soft, flexible tube that runs under your skin from a vein in your chest or neck to a large vein near your heart. One end of the tube stays outside the body. This catheter is a type of central vascular access device. You may have it for weeks, months, or longer.

The catheter gives you medicine, blood products, nutrients, or fluids over a long period of time. It makes getting these things more comfortable for you because they are put into the tube. You are not poked with a needle every time. The catheter may be used to draw blood for tests only if another vein, such as in the hand or arm, can't be used. The end of the catheter sometimes has two or three openings. This is so that you can get more than one type of fluid or medicine at a time.

Your doctor will give you medicine to make you sleep or feel relaxed. Two small cuts (incisions) are made in your body. Your doctor will thread the catheter up a vein in your chest or neck.

After the procedure, you will probably have small bandages where the doctor put in the tube and where it comes out of your body. The area may feel sore for a few days. You may have stitches. Sometimes glue is used instead of stitches.

How can you care for yourself after getting a tunneled catheter?

Activity

  • Talk to your doctor about what activities you can do. You may not be able to do sports or exercises that use the upper body, such as tennis or weight lifting.
  • Avoid arm and upper body movements that may pull on the catheter. These movements include heavy weight lifting and vigorous use of your arms.
  • You will probably need to take 1 day off from work and will be able to return to normal activities shortly after. This depends on the type of work you do, why you have the catheter, and how you feel.
  • Ask your doctor when you can drive again. Pay special attention when pulling your seat belt across your chest so it doesn't pull out the catheter. It's okay if the seat belt lays over the catheter.
  • You may shower 24 to 48 hours after surgery, if your doctor okays it. Cover the area and catheter so they don't get wet. Pat the cut (incision) dry. Don't go swimming.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.

Incision care

  • Your doctor will tell you how to care for the incision at the insertion site. (It's usually on your neck.) It may have stitches, strips of tape, or a gauze dressing. Your doctor will tell you when the stitches will be removed. The strips of tape will fall off in 3 to 5 days. The gauze dressing can be removed after 2 days.
  • Your doctor will tell you how to care for the incision on your chest where the catheter is. It will likely have a clear or gauze dressing on it. A clear dressing usually needs to be changed about 2 days after the procedure and then once a week. A gauze dressing needs to be changed 2 or 3 times a week. Also, change the dressing right away if it becomes wet, loose, or dirty.

Other instructions

  • Go to all appointments to flush the line. This keeps it open. A nurse or other health professional will flush the line.
  • Do not wear jewelry, such as necklaces, that can catch on the catheter.
  • If the catheter breaks, follow the instructions your doctor gave you. If you have no instructions, clamp or tie off the catheter. Then, see a doctor as soon as possible.
  • To help prevent infection, take a shower instead of a bath. Do not go swimming with the catheter.
  • Try to keep the area dry. When you shower, cover the area with waterproof material, such as plastic wrap.
  • Never touch the open end of the catheter if the cap is off.
  • Never use scissors, knives, pins, or other sharp objects near the catheter or other tubing.
  • If your catheter has a clamp, keep it clamped when you are not using it.
  • Fasten or tape the catheter to your body to prevent pulling or dangling.
  • Avoid clothing that rubs or pulls on your catheter.
  • Avoid bending or crimping your catheter.
  • Always wash your hands before you touch your catheter.
  • Wear loose clothing over the catheter for the first 10 to 14 days. When getting dressed, be careful not to pull on the catheter.

How do you prepare for your child's tunneled catheter procedure?

Procedures can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's procedure.

Preparing for the procedure

  • Talk to your child about the procedure. Say that it will help your child get the medicines that your child needs. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the procedure. Your doctor will tell you if your child should stop taking any of them before the procedure and how soon to do it.
  • Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
  • Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.

The day before the procedure

  • A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's procedure and answer any questions.
  • Remember to follow your doctor's instructions about your child taking or stopping medicines before the procedure. This includes over-the-counter medicines.

After your child's tunneled catheter procedure: When to call

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child passes out (loses consciousness).
  • Your child has severe trouble breathing.
  • Your child has chest pain, is short of breath, or coughs up blood.

Call your doctor now or seek immediate medical care if:

  • Your child has symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the area.
    • Pus draining from the area.
    • A fever.
  • Your child has blood draining from the area near the catheter.
  • Your child has swelling in the face, chest, neck, or arm on the side where the catheter is.
  • Your child has signs of a blood clot, such as bulging veins near the catheter.
  • Your child's catheter is leaking, cracked, or clogged.
  • You feel resistance when you inject medicine or fluids into the catheter.
  • Your child's catheter is out of place. This may happen after severe coughing or vomiting or if you pull on the catheter.

Watch closely for changes in your child's health, and be sure to contact your doctor if:

  • You or your child has any concerns about the catheter.

After tunneled catheter placement: Overview

You've had a procedure to give you a tunneled catheter. The catheter is a soft, flexible tube that runs under your skin, usually from a vein in your chest or neck to a large vein near your heart. You may have it for weeks, months, or longer.

You will now be able to get medicine, blood, nutrients, or other fluids with more comfort. You will not be poked with a needle every time.

You can use the catheter right away. You will be shown how to use it and how to care for it.

Your doctor will tell you how to care for the incision at the insertion site. (It's usually on the neck.) It may have stitches, strips of tape, or a gauze dressing. Your doctor will tell you when the stitches will be removed. The strips of tape will fall off in 3 to 5 days. The gauze dressing can be removed after 2 days.

Your doctor will tell you how to care for the incision on your chest where the catheter is. It will likely have a clear or gauze dressing on it. A clear dressing usually needs to be changed about 2 days after the procedure and then once a week. A gauze dressing needs to be changed 2 or 3 times a week. Also, change the dressing right away if it becomes wet, loose, or dirty.

There may be a small ring, or cuff, under the skin on the catheter. This helps hold the catheter in place.

What happens on the day of a tunneled catheter procedure in children?

  • Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the procedure may be canceled. If your doctor told you to have your child take any medicines on the day of the procedure, have your child take them with only a sip of water.
  • Follow the doctor's instructions about when your child should bathe or shower before the procedure. Do not apply lotion or deodorant.
  • Your child may brush their teeth. But tell your child not to swallow any toothpaste or water.
  • Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
  • Be sure your child has something that's a reminder of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

  • A parent or legal guardian must accompany your child.
  • Your child will be kept comfortable and safe by the anesthesia provider. Your child may get medicine to bring on a light sleep or to help your child relax. The area being worked on will be numb.
  • The procedure will take about 1 hour.
  • After the procedure, your child will be taken to the recovery room. As your child wakes up, the recovery staff will monitor your child's condition. The doctor will talk to you about the procedure.
  • You will probably be able to take your child home after he or she is awake and alert and the doctor says it's okay.

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