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Northampton General Hospital NHS Trust

Caring for my central venous access device

This patient guide answers some commonly asked questions about your central venous access device.

What is a Central Venous Access Device (CVAD)?

  • Central venous access devices (CVAD) are semi-permanent indwelling catheters that sit in the large vein leading to the heart.
  • These lines are made of polyurethane and can have up to five lumens (individual chambers) depending on the type of catheter.  The catheters have screw like adaptors on the ends that allow caps, syringes and intra-venous tubing to be securely connected.
  • They are designed for mid and long term access and can be used to administer medications, nutrition, blood or fluids.
  • They can stay in for as long as venous access is required.
  • The lines may be secured by a suture (a stitch), a clamp on a sticky dressing (called a Stat-Lock) or via a cuff which hold it in place under the skin.
  • About 5-12 inches of line will remain visible outside the body.

How is a CVAD inserted?

The CVAD may be inserted in the operating theatre or at the bedside, depending upon the type of catheter and the urgency of need for central venous access. Local numbing of the skin will be used, by a small injection, together with sedation if required. Once the skin has been numbed the patient will only feel pressure on the neck or chest as the Doctor ‘guides’ the line in place.

The benefits of a CVAD

  • Nutrition, fluids, blood, chemotherapy or other medicines can be administered directly into the blood stream.
  • Some medications and nutrition are not safe to be administered in lines in the hands or arms.
  • Can also be used to take blood samples avoiding the need for repeated needle stabs in the arms.
  • Some people are able to be treated at home with the CVAD in place.
  • If you are to go home with a CVAD you will be taught how to care for your line.

The risks of a CVAD

  • Potential bleeding from around the catheter.
  • A risk of infection.
  • Blockage of the catheter can result in the healthcare professional being unable to administer medicines.
  • Too much kinking of the catheter may result in the catheter breaking.
  • A potential risk of developing a clot (thrombosis).

Potential Problems

  • Redness, pain, swelling, odour or oozing at entry site.
  • Raised temperature.
  • Breathlessness.
  • Pain in arm, shoulder or chest.
  • Inability to flush the catheter or resistance to flushing.

If you experience any of the above please contact the healthcare professional who is caring for your line, GP or in an emergency go to the Emergency Department.

Caring for your CVAD

There are things you must do to care for your CVAD and

help reduce the risk of infection:

  • Keep your CVAD clean and dry at the exit site where it comes out of your body, and also at the end where the bung is attached.
  • Try not to get the dressing wet as this can increase the risk of infection.
  • If you are in hospital the nurses or other healthcare professionals will take care of your CVAD, unless you are already familiar with CVAD care and are able to continue to look after your own line.
  • Care of your CVAD line at home is usually delivered by the District Nurse or Intermediate Care Team.
  • If you or a member of your family are willing and able to administer medication at home, you/they will be taught how to do this.

Bathing

  • When you bath or shower, cover the site in waterproof material such as household plastic wrap, taped over the dressing and injection caps.
  • Do not submerge the CVAD site or caps below the level of the water in a bath, hot tub or swimming pool.

Caring for your CVAD

  • Wash your hands before and after touching your CVAD.
  • The line should be kept clamped and flushed once a week.
  • Keep your CVAD line clean and dry.
  • Store your CVAD supplies in a clean, dry place such as a shelf in a cupboard or drawer.
  • The dressing should be changed weekly.
  • Clean your work area with alcohol wipes and let it dry completely before preparing to use your CVAD.
  • Use only sterile supplies.
  • Open all packages carefully without touching the contents.
  • Handle dressings only at the edges.
  • Do not touch the open end of the CVAD when the cap has been removed

 

For further information please contact the Patient Advice and Liaison Service who can signpost you appropriately.

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