Patient education: Lowering the risk of a central line infection (The Basics)

What is a central line? — A central line is a thin tube that goes into 1 of the large veins. It is used to draw blood or give medicines and fluids.

There are many kinds of central lines (figure 1 and figure 2 and figure 3). A central line can stay in place much longer than a regular IV that goes in the hand or forearm.

What is a central line infection? — If germs get into your body through a central line, this can cause an infection.

You are at a higher risk for a bloodstream infection if you have a central line. This is known as a "central line-related bloodstream infection," or "CLRBSI." If this happens, it can be serious.

What increases the risk of a CLRSBI? — The longer you have a central line, the higher your risk for a CLRBSI.

You are also at a higher risk for a CLRBSI if you:

●Are in the hospital

●Have a history of serious illness, such as cancer treated with chemotherapy or bone marrow transplantation

●Have had a lot of skin damage from burns

●Have diabetes that is not well controlled

●Are very young or very old

●Do not take proper care of the central line

Some people go home with a central line. If so, make sure that you and your caregivers know how to care for it. Also make sure that you know who to call if you have questions when you get home.

How can I help prevent a CLRSBI? — It might not be possible to prevent a CLRBSI. But there are some things you can do to lower your risk. Your doctor or nurse will also take steps to lower the risk of infection when inserting the central line.

It's important to understand why you have a central line, and when it can come out. Check with your doctor or nurse often to see if you still need your central line. It should be removed once it is no longer needed, to lower the risk of infection.

Tips to help prevent infection:

●Wash your hands often (figure 4). Wash your hands before and after you touch the central line. Also wash your hands if you are touching the dressing, IV tubing, or blood-drawing equipment. Anyone else who touches the central line should also wash their hands before and after.

●Use the small sponge disc around the central line, if the doctor tells you to. Put it all the way around the central line, with the colored side facing away from your skin.

●Wear a mask and sterile gloves when you change the central line dressing or caps.

●Do not swim or soak in water while you have the central line. (You can do these things if you have a port and it is not accessed.)

Take good care of the central line and tubing:

●Keep the central line covered with a sterile dressing where it enters your body. In the hospital, the nurses will do this. At home, it is easiest if a home health nurse or trained caregiver does this. Replace clear dressings every 7 days. Always change the dressing right away if it is dirty, loose, or wet.

●Keep the central line and tubing secure. This is to prevent the tube from being pulled or catching the tube on anything when you move around.

●Notice the length of the central line outside of your body. If it is suddenly longer, tell your health care team. Do not push it in or pull on it.

●Avoid touching the central line and tubing as much as possible. Do not let others touch the catheter or tubing.

●Tell the doctor or nurse if you notice any changes to your skin where the line enters your body. Also tell them if you notice any cracks or leaks in the central line or tubing.

●Make sure that the line is clamped when not in use, if it is supposed to be. Some lines are not clamped.

Only remove the caps on the lumens when you have to:

●Scrub the caps for at least 15 seconds with a rubbing alcohol wipe on the sides and top. Let them air dry. Do this each time you need to access the central line, for example, to give medicine.

●Change the injection caps on each lumen every 3 to 7 days, or anytime there is a leak. Change the IV tubing as instructed.

●Make sure that the caps are in place and have not wiggled or fallen off. This includes if you are replacing one. Call your doctor if the cap falls off and you have not been taught how to replace it.

What else should I know? — If you are in the hospital, visitors and staff should always wash their hands before and after visiting. If you do not see your doctor, staff, or visitor wash their hands, ask them to.

If you are going home with the central line, the staff will teach you how to care for it.

When should I call the doctor? — Call your doctor for advice if:

●You have any symptoms of infection. These include a fever of 100.4°F (38°C) or higher, chills, or redness, drainage, warmth, stinging, or pain where the line goes into the skin.

●You have problems with the central line:

•The central line falls out all of the way or part of the way.

•There are breaks, cracks, or leaks in the central line.

•You cannot get the medicines or flush solution through the central line.

•You cannot get a blood return from the central line.

•You have any concerns about the central line.

●You have sudden shortness of breath or chest pain.

●You have swelling on the face, neck, or chest on the side of the central line.

●You have swelling or bulging veins around the central line.

More on this topic

Patient education: Central line infections (The Basics)
Patient education: How to care for a central line catheter (The Basics)
Patient education: How to care for a peripherally inserted central catheter (PICC) (The Basics)
Patient education: How to care for a port (The Basics)