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An introduction to your child’s Central Venous Catheter (Broviac®) | Patient Education | UC Davis Children's Hospital

An introduction to your child’s Central Venous Catheter (Broviac®)

Download An Introduction to Your Child’s Central Venous Catheter (Broviac®) information sheet

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
Central Venous Catheter (Broviac®)
Central Venous Catheter (Broviac®)

Inside of the Body

  • The (1) catheter leads to a vein above the heart.
  • The (2) Dacron® cuff is directly under the skin at the exit site. The skin grows around the cuff. The cuff prevents the catheter from being pulled out and also helps keep bacteria from entering the body.

Outside of the body

This is the part that you will be touching and cleaning.

  • The part that sits outside of the body may have one or two smaller tubes (called (3) lumens). Each lumen has a removable cap and a plastic clamp. Medications are injected through the cap into the catheter and travel directly into the vein.
  • If your child has a (4) double lumen catheter, different medications, fluids, or blood products can be infused at the same time. Outside of the body it looks like two lumens that connect into one before entering the body. However, it is two separate tubes and there is no connection between the two lumens

Central Venous Catheter (Broviac®)

Immediately after the catheter is placed, there is a medicated disc (BIOPATCH®) under the clear dressing. After 7 days, the disc is no longer necessary because the skin has healed around the Dacron® cuff. A clear dressing and no medicated disc allow for the exit site at the skin to be easily seen.

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General care

  • Activity

    • Keep tubing off floor.
    • Keep tubing out of diaper area. If possible loop the tubing towards the child’s head and have the tubing come up over his or her shoulder.
    • Do not allow children to chew on the tubing.
    • Children may resume most usual activities. No roughhousing or contact sports. Talk with your doctor for more specific instructions.

  • Baths and showers

    • Do not soak the catheter site under the water.
    • Baths and showers may be resumed after the catheter site is healed.
    • While bathing, cover the dressing with plastic wrap taped to the chest.
    • It is necessary to change the dressing every time it becomes wet.

  • Swimming

    • Only swim if OK’d by your doctor.
    • Never swim in non-chlorinated water such as ponds, lakes or rivers.

  • Clothing

    • Your child should wear snug clothing. Tighter clothing such as onesies, T-shirts or sports bras can help to protect the catheter from coming out accidentally.
Troubleshooting

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:

  1. Clamp the catheter (with smooth clamps) between the child and the break
  2. Cover the break with sterile gauze and tape to chest
  3. 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:

  1. Do not force fluid into the catheter
  2. Make sure there are no kinks or twists along the catheter or under the dressing
  3. Make sure the catheter is unclamped
  4. Pull back on the syringe gently to draw back blood. If blood is visible, attempt to flush again
  5. 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:

  1. Call your doctor or nurse immediately
monkey with fever

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:

  1. Stop infusion into the catheter
  2. 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:

  1. Don’t panic
  2. Apply pressure to site with a sterile gauze
  3. Place the child in a sitting position
  4. Notify your doctor immediately and come to the hospital
  5. 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:

  1. This is an EMERGENCY!
  2. Clamp the catheter immediately, lay the child down on their left side and keep calm
  3. CALL 9-1-1
Important points
kid back to school
  • 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.