“What is a Tunneled Central Venous Catheter (CVC)?” A central venous catheter is sometimes needed as part of your cancer care. There are many types of central venous catheters. You may often hear them called a CVC, or in some cases, a central line, Hickman catheter, or Power Line. Your doctor will decide if you need a CVC, and, if so, which type would be best for you. If your doctor says you need a central venous catheter, it is important for you to understand what the catheter is, why it may be helpful as a part of your cancer treatment, and the precautions you need to take with your catheter at home.
A tunneled CVC is a special type of intravenous or I.V. catheter that is put into a large vein under your collarbone. This catheter is a long, thin flexible tube that is tunneled under the skin and then leaves the body through an area usually in the upper chest. The part of the catheter that exits your body may have one, two, or three tips. The tips will be closed with a clamp and a special cap. The other end of this tunneled catheter stays inside your body, in the vein. Tunneled CVCs can be used for your cancer care when you are in the hospital, at the doctor’s office, or while you are at home.
This type of catheter can remain in place for several weeks or months, if needed. Based on your cancer treatment, your doctor may have different reasons for choosing to use a tunneled CVC as part of your care. For example, chemotherapy may be given through this CVC, which helps decrease the use of your arm veins for treatment. Blood samples may be taken from this type of catheter, which helps to lessen your number of needle sticks. This can be very helpful in reducing bleeding or bruising. Your health care team can also use your tunneled CVC for intravenous—or IV fluids, IV medicines, or, if needed for blood transfusions. In some cases, based on your health needs, total parenteral nutrition—sometimes called TPN—can also be given through this special type of catheter. If the decision is made for you to have a tunneled CVC, you will be scheduled for the catheter to be put in at the hospital.
When you arrive on the day your catheter will be placed, you will get some medicine to help you relax–it may even make you a little sleepy. Medicine will also be given to numb your chest, neck, and shoulder to make the procedure more comfortable. Next, the doctor will make two small incisions on your chest so the catheter can be put into place. One incision will be made at the bottom of your neck, near your collarbone. The other incision will be made lower on your chest, above your nipple. The doctor will close the incisions with stitches, special surgical glue, or surgical strips, which look like tape. The incisions will be covered with a dressing. Most incisions heal in about 7 to 10 days. However, you may have some bruising, swelling, or tenderness for the first few days after this procedure. Your doctor, or a member of your health care team, will tell you how to take care of your incisions until they are healed.
After the tunneled CVC is put into place, you will see one end of the catheter taped to your chest to hold it in place. The other end of the catheter that you cannot see, will sit in a large vein above your heart. For the first few weeks after your tunneled CVC is placed, you should not do any strenuous exercise or activities, such as jogging, mowing, or shoveling. This is to help your incisions heal. After the incisions have healed, you should be able to return to your normal activities. Your doctor will talk to you about any special precautions if you need to limit certain activities, sports, or exercises. Because it is important to keep the catheter site dry and clean, you will not be able to swim, use bathtubs or whirlpools.
You can shower, but your healthcare team will show you how to cover the tunneled CVC site to keep it dry. You will also need to be careful to keep sharp objects away from your tunneled CVC, such as scissors, hair trimmers, clippers, or razors. Your doctor and other members of the health care team will give you special instructions about how to care for your tunneled CVC to lower the risk of problems, such as infection. You must take special care of the catheter that stays outside of your body, and the skin around the area where it exits your chest. You and your caregiver will be shown how to clean the catheter site and how to change the catheter dressing. A member of your healthcare team will show you how to flush the catheter, so that it does not get clogged or blocked, and how to change the small injection cap at the end of your catheter.
It is very important to only touch your catheter or the dressing when you are caring for it. Wash your hands before starting any care for your catheter, to help prevent infection. Special care is also needed to make sure the catheter is not pulled out. You will be shown how to tape the catheter to your chest, and how to wear clothing so it does not pull on the catheter. Written material will be given to you that includes all tunneled CVC instructions to review, whenever needed. Make sure all of your questions are answered during your teaching sessions, to make sure you and your caregiver understand how to care for your catheter. It is important to tell your healthcare team how you are feeling.
There may be times when you need to call the doctor if something changes. A fever can be life threatening for patients with cancer. Call your doctor right away if your temperature reaches 1degrees Fahrenheit or higher. You should tell your doctor if there is increased bleeding, drainage, bruising, tenderness, pain, or redness from your incisions. Call your doctor right away if you feel dizzy—or if your face, neck, chest or arm become painful or swollen on the same side in which your catheter was placed. You should also call your doctor if your tunneled CVC does not flush well, or if you are worried that it may be plugged or blocked. If there are any questions or problems with your tunneled CVC, you should tell your doctor. In some cases, you may need to call your emergency phone number, which in most areas is 9-1-1. Call if you have shortness of breath or any trouble breathing, chest pain, or have severe bleeding from an incision area. If you do have an emergency with severe bleeding hold firm pressure on the site until the emergency responders arrive.
Also call 9-1-1 if your tunneled CVC is accidentally pulled out. If the catheter comes out, cover the area with a clean dressing and hold firm pressure on the site until help arrives. Now, let’s review some important points we have covered. In order to take the best care of yourself, you will need to: Follow your doctor’s orders on what activities you may or may not do. Remember to keep the area where the tunneled CVC exits your skin, clean and dry. Keep sharp objects away from the catheter.
And, follow the special instructions your doctor and other health care team members give you about how to…clean the site where the catheter exits your skin, change the dressing, flush the catheter, and change the cap on the catheter. And last: It is important to call your doctor right away if you have a fever of 1degrees Fahrenheit or higher. You should also call your doctor if: The incisions have increased bleeding, discharge, bruising, tenderness, pain or redness. Call if you become dizzy; or, if there is swelling or pain in your face, neck, chest or arm, on the same side where your catheter was placed. You should also call your doctor if your tunneled CVC does not flush well or if you are worried that it may be plugged or blocked or if you have any other questions or problems with your catheter Call 9-1-1 for emergency help if: You have shortness of breath or any trouble breathing; chest pain, or severe bleeding from your incision area; or, if your tunneled CVC is accidentally pulled out.
We hope this information has helped you to better understand how a tunneled CVC may be used for your care. Write down any questions you might have for your health care team, and bring them with you to each appointment. We are honored to care for you during your cancer treatment. Thank you for choosing The James..
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