Non-tunnelled central venous catheter (CVC) factsheet
Introduction
A non-tunnelled central venous catheter (CVC) is a tube inserted into a large vein in the neck or groin.
Your child may have one if they:
- need treatment for up to two weeks
- are in a medical emergency
- have small or hard-to-find veins.
It allows medicine or fluids to go straight into the bloodstream and can also be used to take blood. It is also called a jugular or femoral line.
Before the procedure
Before the procedure, the treatment team will explain:
- when your child needs to stop eating and drinking
- what time to arrive
- what to bring.
They will answer any questions and explain how the CVC works and how to care for it.
If the CVC is inserted in an emergency, staff will give you the information you need to give consent for the procedure. Consent means that you understand and agree to the procedure.
During the procedure
A surgeon will insert the non-tunnelled CVC while your child is under general anaesthetic. This means your child will be asleep and won’t feel any pain.
The procedure is usually done in:
- an operating theatre
- the emergency department, or
- the intensive care unit (ICU).
The surgeon will use a needle to access a vein in the neck or groin. They will then guide the tip of the catheter into a large vein called the superior vena cava.
After it is inserted, an x-ray is used to check the CVC is in the correct place.
After the procedure
Your child may have some bleeding around the cut in the neck or groin, which should stop shortly after.
The non-tunnelled CVC is held in place by using:
- a clear dressing – protects the site from infection and keeps it clean and dry
- a securement device - supports the line helps prevent movement.
These must stay clean, dry, and firmly in place.
Management
Flushing and locking
Flushing is when a normal salt water or saline solution is pushed into the CVC by a syringe. This helps to stop it from becoming blocked and is done after medication has been given.
Locking is when an anti-blood clotting and antibacterial solution is left in the CVC if it’s not used for a few days to a week. This helps prevent infection and blockages.
Removing the non-tunnelled CVC
The CVC is removed when:
- treatment finishes
- it stops working properly
- there is another issue.
The non-tunnelled CVC can be removed in hospital without general anaesthetic.
Common problems with the non-tunnelled CVC
While serious problems are rare, knowing about the risks is important.
Bleeding
Mild bleeding is common after the procedure and usually stops quickly in the first day or two.
Very rarely, serious bleeding can happen, such as:
- a haemothorax – bleeding into the chest
- cardiac tamponade – bleeding around the heart.
Infection
Infection can happen when germs get into the body through a cut or opening.
The hospital will ensure everything is clean and sterile, or free of germs, when the non-tunnelled CVC is inserted.
Go to the emergency department if you notice signs of infection, including:
- redness
- pain
- heat
- swelling
- fever over 38°C.
Infections are treated with antibiotics. Severe infection can also mean the CVC needs to be removed or replaced.
Damage to the catheter
Check the outer tubes and lumens in your child’s non-tunnelled CVC for any damage or cracks.
If you see fluid under the dressing:
- clamp the line
- go to the emergency department.
Accidental removal and positioning
If the CVC is pulled out or moved:
- stop all fluids or medicine
- clamp the line
- apply pressure on the neck and chest sites
- call triple zero (000) for an ambulance
- call your child’s doctor while you wait for the ambulance.
If it becomes harder to use the line, tell your child's doctor right away.
Blockage
Flush the CVC after each use and weekly if unused. If it becomes blocked, try flushing. If that fails, the CVC may need to be replaced.
Air bubbles
Always check syringes for air bubbles. If there’s a leak or break, clamp the line right away to stop air from entering.
Blood clots
Clots can form around the CVC in the vein. They often cause no harm and can be treated with medication. If they cannot be treated, the CVC may be removed.
Serious complications
Serious but rare complications can include:
- severe infection
- damage to the walls of the blood vessels or heart
- cardiac tamponade - fluid or blood collecting around the heart
- a haemothorax - fluid or blood collecting in the chest.
Your child may need surgery to treat serious complications. Ask your child’s doctor if you have any questions.