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.
What to do
The catheter accidently comes out
The infusor becomes disconnected from the catheter
The NAD has fallen off
The catheter breaks
Your child develops fevers, swelling, redness or pain at the catheter entry site or up the arm
The dressing becomes loose, wet or dirty
The catheter appears longer or shorter
Leakage or drainage at the catheter site
Blood in the catheter
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
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.