An introduction to your child’s Central Venous Catheter (Broviac®)
This webpage will teach you about your child’s central venous catheter, how to care for it at home, and what to do if there is a problem. The catheter may also be called a tunneled central line or sometimes a Broviac®.
The goals of catheter care are to keep the catheter working properly and to avoid infections. To properly care for the catheter, you must learn to do daily flushes and weekly dressing and cap changes.
Why does my child need a Central Venous Catheter (Broviac®)?
- To decrease the number of times your child is poked with a needle.
- To administer medications and fluids into a large vein.
- To draw most blood samples.
What is a Central Venous Catheter (Broviac®)?
- A surgically placed line put into a vein in your child’s chest
- A catheter that can stay in place until your child’s medical treatment is finished
- Typically made of soft, flexible plastic with a removable hard plastic cap on the end
After the catheter is placed:
- After surgery, your child may feel sore for a day or two and the area may be swollen.
- The skin above the catheter will have small incisions covered with small sterile tape (Steri-strips®).
Things to know before you go home:
- How to flush the line every day and after each use
- How to change the dressing every 7 days (or when needed)
- How to change the injection cap every 7 days
- When to call the doctor
- What to do in case of an emergency
Leaking of fluids, hole or break in catheter
How to Avoid:
- Make sure catheter is looped and secured at all times
- Avoid pulling or tugging on the catheter
- Remember to clamp tubing in the area that states “clamp here”
- Never use scissors or sharp objects near the catheter
- Never use excessive force to flush the catheter
Possible Problem: Break or cut in catheter
What to Do:
- Clamp the catheter (with smooth clamps) between the child and the break
- Cover the break with sterile gauze and tape to chest
- Notify your home health nurse or doctor immediately and bring your child to the hospital
Unable to flush catheter with normal pressure
How to Avoid:
- Make sure to flush with heparin at least once a day
- Flush with heparin after each use
- Use push-pause method to flush
Possible Problem: Clot or kink in the catheter
What to Do:
- Do not force fluid into the catheter
- Make sure there are no kinks or twists along the catheter or under the dressing
- Make sure the catheter is unclamped
- Pull back on the syringe gently to draw back blood. If blood is visible, attempt to flush again
- If unable to flush the catheter, clamp the catheter and call your nurse or doctor immediately
Temperature greater than 100.4˚ F or as instructed by your doctor
Chills, fatigue or a decrease in activity
Swelling, warmth, tenderness, redness, oozing, odor or drainage at the exit site
Pain or swelling along catheter tract or pain while flushing the catheter
How to Avoid:
- Wash hands before beginning any care with catheter
- Inspect catheter site with each dressing change
- Avoid contact with people who are ill
- After first week exit site needs to be visible at all times. Use a clear dressing to see problems at the site
- Keep tubing away from diaper area
Possible Problem: Infection
What to Do:
- Call your doctor or nurse immediately
Swelling under the skin of neck and face and/or shoulder
How to Avoid:
- Inspect catheter and skin during flushes, dressing changes and cap changes
Possible Problem: Internal problem with catheter
What to Do:
- Stop infusion into the catheter
- Call your doctor or nurse immediately
Catheter not in chest or blood on the dressing or clothing
How to Avoid:
- Make sure the catheter is looped and secured at all times
Possible Problem: Accidental removal of catheter
What to Do:
- Don’t panic
- Apply pressure to site with a sterile gauze
- Place the child in a sitting position
- Notify your doctor immediately and come to the hospital
- Save all the parts for examination
Shortness of breath or complains of chest pain
How to Avoid:
- Always clamp catheter before removing cap
- Keep catheter clamped when not in use
- Make sure cap is always screwed securely onto catheter
Possible Problem: Air in the catheter
What to Do:
- This is an EMERGENCY!
- Clamp the catheter immediately, lay the child down on their left side and keep calm
- CALL 9-1-1
Important points
- Be sure your child’s teachers, school nurse, and PE teacher know about the central venous catheter.
- Periodically check the catheter for any cracks or signs of damage.
- Always carry extra caps, clamps and dressing supplies.
- Do not use supplies if they fall on the floor.
- Do not use sterile parts if they have been accidentally touched.
- Do not use medications if they are out of date or if seals are not intact.
- Do not give Tylenol® or Motrin® unless instructed by your doctor.
It is important that any doctors or nurses taking care of your child know that your child has a catheter. This is especially important if your child is being seen in another clinic or emergency department.
