Care of an uncuffed tunnelled central venous catheter

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

PDF Versions Available

This fact sheet is available to print in the following languages:

An ‘uncuffed tunnelled central venous catheter’ is a plastic tube that is inserted into a large vein in the neck. The catheter goes under the skin and comes out onto the chest. The tip of the catheter ends in a big vein close to the heart and can stay here for a long period of time so your child can receive intravenous medication or fluids at home. Most of this catheter will not be visible; only a small section of the catheter remains outside the body and will have one or two openings or ‘lumens’. This is where the medicine is attached.

A clear dressing and a securement device is used to secure the catheter to the chest. The dressing covers the catheter and keeps it clean and dry to prevent infection. The securement device prevents the catheter from being pulled back or pulled out.

The catheter will be checked by your ‘Hospital in the home’ nurse at every home visit, and will be removed on completion of treatment. Your child will need to return to the hospital to have the catheter removed, but this can be done in the Acute Review Clinic by a nurse without anaesthetic. The removal procedure is very quick and shouldn’t be painful, but please be aware that an observation period of 60 minutes is required after removal.

General care of the catheter

  • Strict care of your child’s catheter is very important to prevent infection. This involves careful hand washing and wearing gloves when connecting and disconnecting the infusion sets from the catheter, and also during dressing changes.
  • Make sure that the dressing covering the catheter is kept clean and dry at all times.
  • When bathing your child make sure the catheter is kept out of the water to prevent the risk of infection.
  • Keep the catheter secure and regularly check the dressing to make sure it’s not coming off.
  • Dressings are changed every 7 days. This involves carefully removing the old dressing and cleaning the skin around the catheter with antiseptic solution and applying a new clean dressing.
  • Check the catheter regularly to make sure that the catheter is not kinked and the catheter outside the body has not changed length.
  • Take care when dressing your child to make sure that the catheter is not accidently removed or pulled.
  • Make sure the Needleless Access Deceive (NAD) on the end of the catheter stays connected at all times.
  • Do not allow anyone to touch the catheter.

When to seek help:

If your child has any of the following problems, follow the instructions below and contact either the HITH nurse or your child’s relevant after-hours medical team immediately.

 

 

 

 

 

Problem 

What to do

The catheter accidently comes out

  • Lie your child down and apply firm pressure over the site with cotton wool or a clean disposable towel for 5 minutes to stop the bleeding. Then cover the site with a spare dressing.

The infusor becomes disconnected from the catheter

  • Clamp the catheter, do not reconnect.

The NAD has fallen off

  • Clamp the catheter immediately.
  • If unable to clamp the catheter, bend the catheter and tape it firmly together.
  • Attach a new NAD to the end of the catheter, DO NOT replace the old NAD back onto the catheter.

The catheter breaks

  • Stop the infusion.
  • Using the clamp on the catheter, clamp above the break closest to the catheter insertion site (skin). If unable to clamp the catheter, bend the catheter above the break and tape the line firmly together. Cover with a gauze square or a clean disposable towel to keep clean. Secure the catheter with spare dressing.

Your child develops fevers, swelling, redness or pain at the catheter entry site or up the arm

  • Stop the infusor and clamp the catheter.

The dressing becomes loose, wet or dirty

  • Do not remove the dressing; secure the dressing with spare dressing.

The catheter appears longer or shorter

  • Secure the catheter with spare dressing to prevent further movement.

Leakage or drainage at the catheter site

  • Clamp the catheter and stop the infusion.

Blood in the catheter

  • Clamp the catheter and stop the infusion.

Contact details

HITH Service (Westmead):

Contact Times: 7.30am to 9.30pm 7 days a week

Contact Numbers: Office: 98453857 / Morning nurse mobile: 0417226650 / Afternoon nurse mobile: 0419226590

HITH Service (Randwick):

Contact times: 7.30am to 9.30pm 7 days a week

Contact numbers: Office: 93820228 / Morning Nurse Mobile: 0418760411 / Afternoon Nurse Mobile: 0409954567

After Hours:

Please phone the Children’s Hospital at Westmead on 98450000 or the Sydney Children’s HospitalRandwick on 93821111 and ask to speak to the Registrar on call for your child’s consultant for further instructions.

logo
The Children's Hospital at Westmead
logo
Sydney Children's Hospital, Randwick
logo
Hunter New England Kids Health
www.hnekidshealth.nsw.gov.au

For publications recommended by our hospitals' experts, please visit the Kids Health book shop.