Living with a Central Line

Living With a Central Line

Here are some important tips about caring for a Central Venous Catheter (CVC) or “Line” at home.

Hygiene

It is important to keep your child’s skin, hair, and mouth clean. Bacteria from these areas can cause an infection in their central line. It is very important for your child to bathe every day and more often as needed for soiled clothing or contact with bodily fluids. If your child’s central line dressing becomes wet and/or lifts up after bathing, it needs to be changed immediately.

Your child should wash with Chlorhexidine (Hibiclens) soap daily (unless he or she has an allergy to chlorhexidine). This special soap kills bacteria during the bath and for up to 24 hours after bathing. If your child has any rashes or open areas in their skin- avoid these areas when bathing with Chlorhexidine.

To bathe with Chlorhexidine when your child’s central line is located in his/her upper chest:

1. Curl central line end up and cover central line dressing/line with Press N’ Seal and tape a “window” around Press N’ Seal. This DOES NOT mean that your child can soak in water, it will ONLY protect against splashing.
2. Bathing your child with a central line at home can be done in a few different ways depending on your child’s age and ability to follow directions:
   • Babies can be washed in an infant tub filled with a small amount of water, be careful to keep water level low enough that line is not touching/soaking in water.
   • Toddlers that are able to sit independently and young children can bathe in a bathtub filled with water to waist level or just below waist level. Be sure to always stay within arm’s reach of your child to prevent them from submerging line. When pouring water over your child be careful to avoid pouring water over the line.
   • If your child is able to stand and follow directions, bathing can be done in the shower, facing away from the water and tilting head back to wash hair.
3. Wash hair first with regular shampoo and rinse well to remove any residue from hair/body (Rinse body well with water from neck down (this can be done in a shower facing away from the water, in a bathtub filled with water to waist level, or with a wet washcloth out of the bathtub).
4. Apply chlorhexidine soap directly onto your child’s skin or onto a wet washcloth and wash their body gently. Do NOT use Chlorhexidine soap on your child’s face. If showering, ensure your child is standing away from the water to wash.
5. Rinse thoroughly with warm water.
6. Do not use regular soap after using chlorhexidine soap.
7. Dry skin well with a towel.
8. If lotions are needed, use only those compatible with chlorhexidine.
9. Put on clean clothes after bathing.
10. This is not an "all inclusive" list. See manufacturer's website for further details.

Oral Care

Your child’s teeth should be brushed twice a day or after every meal if your child eats by mouth. Teeth should be brushed with a soft toothbrush and toothpaste for two minutes. Flossing should be done daily. Mouth should be rinsed with water after brushing and flossing if your child is able to follow directions to spit. If your child has difficulty with spitting and/or swallowing, teeth can be brushed with a very small amount of water and a small amount of fluoride-free toddler toothpaste. Baby’s mouths/gums can be cleaned with a gauze moistened with water.

Activity

It is important to be careful with your child’s central line and to always make sure that the line is not pulled during activity. Gus Gear central line wrap should be used at all times to help secure central line dressing and tubing. Be mindful when you are picking a child up out of a crib, swing, high chair etc. that you know where their tubing is and that the line will not be pulled during lifting. We want your child to be as active as they would like! If you have any questions about how to support this at home, please contact our office and we can work with you to help with any concerns you have.

Environment

Because your child’s central line places him/her at an increased risk for infection, it is important to keep his/her home safe.

• Your child’s sheets and any other bedding should be washed with hot water every week or more frequently if they become dirty. Limit stuffed toys unless these can be washed.
• Clothing should be kept clean and dry and changed daily or as needed if they become dirty.
• Clutter should be cleared from floors to prevent catching and pulling on central line, or tripping and falling.
• Your child’s toys should be cleaned regularly, especially those that are placed in your child’s mouth.
• Pets should be monitored carefully to avoid tangling or pulling on central line tubing.
• Environment during central line care:
  • Central line care should not take place in a bathroom.
  • Fans/air conditioner should be turned off and windows and doors should be closed.
  • To the best of your ability, limit distractions and use the assistance of another adult.
  • Use your designated supplies and surface for all central line care.
  • Pets (and ideally anyone not needed during the central line care) should not be in the room during line care.