Learning about a central vascular access device for children

What is a central vascular access device?

A CVAD is a thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time. It's also called a central line. It makes giving these things more comfortable because they are put directly into the line. That means your child is not poked with a needle every time. It may be used to draw blood for tests only if another vein, such as in the hand or arm, can't be used.

The CVAD is inserted through the skin into a vein in your child's chest, neck, groin, or arm. One end is moved into a large vein near the heart. In most cases the other end sticks out where it entered the skin. The end of the line that sticks out of the skin has caps on it. The health care team gives medicine or removes blood through the caps.

A baby in the neonatal intensive care unit (NICU) often has a line placed through the belly button. The NICU is the part of the hospital where premature or sick newborns are cared for.

Some of the common CVADs that are used outside the hospital or for longer periods of time include:

• A peripherally inserted central catheter, or PICC line (say "pick"). It often goes into a vein in your child's arm, and one end of the line sticks out of the skin.
• A tunneled catheter. It is surgically inserted into a vein in the neck or chest, and one end of the line sticks out of the skin.
• An implanted port. This is similar to a tunneled catheter but is left entirely under the skin. Medicines are injected through a "port" placed under the skin.

What happens when your child gets a central vascular access device?

In the hospital, a health care team will take care of your child and their CVAD.

Insertion and care of the CVAD

Your child's team will:

• Check the site and dressing regularly. How often this is done depends on the situation.
• Wash their hands before and after handling the CVAD.
• Clean or replace the parts when needed.

Changing the dressing

The team will:

• Use clean and proper materials for the dressing, which covers the site.
• Clean the site and area whenever they change the dressing.
• Replace the dressing when it is damp, loose, or dirty. It will be changed regularly.

Home care

If your child goes home with a CVAD, the team will give you detailed instructions on how to care for it and what to do if any problems occur. In general:

• Always wash your hands before you touch your child's CVAD. Make sure anyone who touches it also washes their hands.
• Try to keep the skin at the site dry. This can help prevent infection. When your child showers or bathes, cover the site with waterproof material, such as plastic wrap. Be sure you cover both the CVAD site and the cap(s).
• Fasten or tape the CVAD to your child's body to prevent it from pulling or dangling. Avoid bending or crimping it. And have your child wear clothing that doesn't rub or pull on it.