Discharge Instructions: Caring for Your Central Line

Discharge Instructions: Caring for Your Central Line

You are going home with a central line. It’s also called a central venous access device (CVAD) or central venous catheter (CVC). A small, soft tube (catheter) has been put in a vein that leads to your heart. This provides medication during treatment, and is taken out when you no longer need it. At home, you need to take care of your central line to keep it working. And since a central line has a high infection risk, you must take extra care washing your hands and preventing the spread of germs. This sheet will help you remember what to do at home.

Healthcare provider talking to woman in hospital gown.

Understanding Your Role

  • A nurse or other health care provider will teach you and your caregivers how to care for the central line. Before leaving the hospital, make sure you understand what to do at home, how long you may need the central line, and when to have a follow-up visit.

  • You will likely be told to flush the central line with saline or heparin solution. You may also be told to change the catheter’s injection caps and change the dressing (bandage). Or, a nurse may do this for you during a follow-up visit. Only do these things if you’re told to, following the instructions you were given.

Protecting the Central Line

If the central line gets damaged, it won’t work right and could raise your chance of infection. Call your health care team right away if any damage occurs. To protect the central line at home:

  • Prevent infection. Use good hand hygiene by following the guidelines on this sheet. Don’t touch the catheter or dressing unless you need to. And always clean your hands before and after you come in contact with any part of the central line. Your caregivers, family members, and any visitors should use good hand hygiene, too.

  • Keep the central line dry. The catheter and dressing must stay dry. Don’t take baths, go swimming, use a hot tub, or do other activities that could get the central line wet. When showering, cover the area with plastic wrap or another cover as recommended by your health care provider. And keep the area out of the water spray. If the dressing does get wet, change it only if you have been shown how. Otherwise, call your health care team right away for help.

  • Avoid damage. Don’t use any sharp or pointy objects around the catheter. This includes scissors, pins, knives, razors, or anything else that could puncture or cut it. Also, don’t let anything pull or rub on the catheter, such as clothing.

  • Watch for signs of problems. Pay attention to how much of the catheter sticks out from your skin. If this changes at all, let your health care provider know. Also watch for cracks, leaks, or other damage. And if the dressing becomes dirty, loose, or wet, change it (if you have been instructed to) or call your health care team right away.

  • Avoid lowering your chest below your waist. This includes bending at the waist for actions like tying your shoes. When your chest is positioned below your waist, especially for a long time, the catheter’s internal tip could slip out of place in the vein.

  • Tell your health care team if you vomit or have severe coughing. This can also make the catheter slip out of place.

Risk of Blood Clot

If a blood clot forms it can block blood flow through the vein where the catheter is placed. Signs of a blood clot include pain or swelling in the neck, face, chest or arm. If you have any of these symptoms, call your health care provider right away. You may need an ultrasound exam to locate the blood clot and receive treatment with a blood thinner.  

Prevent Infection with Good Hand Hygiene

A central line can let germs into your body. This can lead to serious and sometimes deadly infections. To prevent infection, it’s very important that you, your caregivers, and others around you use good hand hygiene. This means washing your hands well with soap and water, and cleaning them with alcohol-based hand gel as directed. Never touch the central line or dressing without first using one of these methods.

To wash your hands with soap and water:

  1. Wet your hands with warm water. (Avoid hot water, which can cause skin irritation when you wash your hands often.)

  2. Apply enough soap to cover the entire surface of your hands, including your fingers.

  3. Rub your hands together vigorously for at least 15 seconds. Make sure to rub the front and back of each hand up to the wrist, your fingers and fingernails, between the fingers, and each thumb.

  4. Rinse your hands with warm water.

  5. Dry your hands completely with a new, unused paper towel. Don’t use a cloth towel or other reusable towel. These can harbor germs.

  6. Use the paper towel to turn off the faucet, then throw it away. If you’re in a bathroom, also use a paper towel to open the door instead of touching the handle.

When you don’t have access to soap and water: Use alcohol-based hand gel to clean your hands. The gel should have at least 60% alcohol. Follow the instructions on the package. Your health care team can answer any questions you have about when to use hand gel, or when it’s better to wash with soap and water.

When to Call Your Health Care Provider

Call your provider right away if you have any of the following:

  • Pain or burning in your shoulder, chest, back, arm, or leg

  • Fever of 100.4°F (38.0°C) or higher

  • Chills

  • Signs of infection at the catheter site (pain, redness, drainage, burning, or stinging)

  • Coughing, wheezing, or shortness of breath

  • A racing or irregular heartbeat

  • Muscle stiffness or trouble moving

  • Gurgling noises coming from the catheter

  • The catheter falls out, breaks, cracks, leaks, or has other damage