Central Line Tips and Tricks

I was curious if anyone has any tips/tricks to keep a central line open when it comes to drawing blood back for tests (e.g., something better than TPA)?

Report post

8 replies. Join the discussion

I've been told to not draw blood from the line unless it's absolutely necessary. Whenever I need to get blood drawn, I just have them do it peripherally. I'd much rather have a small needle stick in my arm than risk my line clogging or getting infected, haha.

Report post

While I use TPA to dissolve clots, I use it sparingly because, when I used it prophylactically, as suggested by my nutrition team (monthly), it ended up making swiss cheese out of my catheter (as described by my IR surgeon). Because I am prone to clotting, I have gotten into the practice of flushing my lines with 10cc of saline several times throughout the day, as suggested by my IR surgeon. I am allergic to heparin, but for those who use it, remember not to use it each time you flush (if you choose to flush several times a day) because it is an anti-coagulant, aka a blood thinner. I keep two doses of TPA in my freezer for those times when my catheters become "stiff" and it is on a Sunday or during a time when my pharmacist is unavailable.

Actually, I am down to my last viable vein, as the others have become bulging and blue from having scarred over from previous lines. What is that condition call (aside from bad)? I am desperately trying to preserve this existing line. The surgeon placed a catheter stabilization devise, called "StatLock", around my catheter when the cuff became exposed rather than pulling it. He said that he wouldn't consider using the groin because of the risk factors of infection, etc. I could use some feedback if anyone has any abt the state of being on my last vein. What happens if that vein becomes un-useable?

Report post

My peripheral veins are terrible, so most of the time I have no choice but to use my central line for blood draws. I flush immediately after the nurse finishes obtaining all of the blood she needs, while she is still fiddling around with the tubes of blood - I don't like to waste precious time. I use thirty ccs of saline, to make sure the line is well flushed, and then finish with 500 mg heparin. This line is terrific; I've had it for over 2 1/2 years and it has never clotted! Not so with my previous line, which had been poorly installed. I needed tpa every six weeks or so. The surgeon who placed the newer one used the same site as the old one, but did angioplasty on the vein. I have never had a line that's been so easy to take care of! I get a good blood return, blood draws are easy, and it flushes well. Judi - I think the word you are looking for is "thrombosed". My superior vena cava is thrombosed, so I can no longer have lines in my chest. I've had two lines in my groin, and infection has not been a problem. I had the one line for seven years, until the lumen became so narrowed that nothing could go in or out of it. The line starts in my groin (femoral vein) and goes up to the inferior vena cava. The port itself is on my right leg. Even if you don't have a port, the catheter could be tunneled under the skin so that it comes out through, say, your abdomen. There was an initial incision in the groin when the line was installed, but that closed up.

I've attended breakout sessions at Oley meetings about line issues, and I am under the impression that the experts can always find a place to put a central catheter! I've heard of people having them placed in veins such as the lumbar-sacral.

One other thought: I take coumadin to keep my blood somewhat thin and prevent clots.

Davi

Report post

I have a port-a-cath and have had it accessed long term several times. So as far as keeping it open, heparin is your best friend. Flush it every 24 hours when your not using it, or after your meds/TPN when you are using it. I also was liberal with using saline. Also if you doing pulsing pushes that can help clear the line.

As far as drawing blood from those lines it's totally fine. Just make sure who ever does it wipes the ports with alcohol before drawing from it, washes their hands and uses clean gloves. I've had my port in for 8 years and it's never been infected.

Feel free to e-mail me or reply if you have more questions.

Jess

Report post

Hello,
I´m from Holland and i apologize for sometimes not using the right words and terms.
my wife has also a central line since february this year and we try to keep it open by using daily Natriumchloride 0,9% put with much power with a 10 ML syringe with a 0.6 injection needle. This combination takes care of a twirl (if you know what i mean) and so cleans the line.

Since 2 months my wife also does´nt use heparine anymore. Several European universities (among wich UMC St Radboud Nijmegen) has tested very succesfully the use of 10 ml Taurosept (Taurolidine solution 2 %) Since the last time she had a infection (the third one) on the line she gets Taurosept as a lock of the line for at least 1,5 hour after the nutrition has ended.
Now we can say "so far so good" and we are very happy with the result until now.

Report post

lock the line for 1 hour with alcohol-- prevents line infection.....learned this from the experimental Omegavan drug MD website (Boston Medical). Used to lock with Vanco, but with resistance factors, this is the ideal way for us and the Broviac.

Report post

i have had my hickman for almost 6 years. never had a problem so far with infections or blood draws.. i wonder what size line you all have put in? mine is a 12fr. double lumen. we draw blood , (used to be weekly) now every other week. 4 tubes at a time. just squirts right out. when i had my PICC lines i would have some difficulty drawing blood after about a year. those tended to get fibrin sheaths over the ends, but not necesarrily a clot. what size lines do you all use, it would be interesting to see what we all have.

Report post

I have had enormous problems with infection with my port a catheters. I have a condition Behcet's (autoimmune disease of blood vessels etc.) which affects clotting and they NEVER can get a peripheral stick.....if they have to they will go in my groin to test blood (as they had to do for the testing re the port a cath). We are very cautious and use all proper procedures....Yet my first port a cath lasted 7 months before I developed a severe staph infection which became systemic (and it was removed)...Then 2 weeks ago, I ended up at ER with 103, quickly jumping to 106 degree temps leading to 9 day admission in ICU and stepdown ICU due to systemic negative gram e-coli infection from the port a cath which created a sepsis situation.....At the moment, I have a PICC line put in 2 weeks ago so we can complete the IV antibiotics which ends tomorrow at midnight....PICC lines used for me in the past don't last very long so we'll see what happens to this one pretty soon.

Report post

This discussion is closed to replies. We close all discussions after 90 days.

If there's something you'd like to discuss, click below to start a new discussion.

Things you can do

Support the Oley Foundation

Help the Oley Foundation reach its goals and support people like yourself by making a donation today.

Donate to the Oley Foundation

Discussion topics

Helpful links from the Oley Foundation

Community leaders