Central Line Care: Strengthening Protection Against Hospital Acquired Infections (HAIs)

| Last updated on November 3, 2023

Central lines are a direct connection between critical medical intervention, like life saving medication, and the heart. They can be used for tiny babies, children and adults of all ages. 

Patients who have long-term central lines are often fighting serious illnesses, and may be immunocompromised, making central line care a high stakes priority. 

Such a critical connection requires special care and advanced technology to keep lines functioning and to protect patients from the risks that can come with having a central line. 

When the best evidence-based safety guidelines are paired with the right technology, like CLABSI conscious technology, patients can be protected and feel reassured that they have the most freedom possible from the risk of healthcare associated infections.  

Below, we’ve curated guidance from leading hospitals and medical centers and have included central line technology considerations to support patients, caregivers and healthcare workers with elevating central line care. 

In this article access information on: 

  • What a central line is
  • When central lines are used
  • Why it’s important to care for your central line
  • How to care for your central line 
  • Advanced central line technology 

What is a central line?

Central lines - also called venous catheters - are similar to standard intravenous or “IV” lines

Central line catheters are much longer than IV lines, and are inserted either into the larger veins that connect to the heart, or are inserted directly into the heart.

Central lines can remain inserted for up to a year, and are used to provide patients with:

  • medicines,
  • fluids,
  • nutrition, or,
  • blood

They can even be used to draw blood from patients when necessary.

Both inpatients and outpatients can have central lines. Patients may be given central lines when they are rushed to intensive care units and are in immediate need of antibiotics, blood transfusions, pain medications, or other fluids. 

Many patients also live with long-term central lines - which can remain inserted for a year or more - for ease of administering medical treatments or drawing blood for routine medical testing to monitor illnesses. 

What does a central line look like?

Like a regular IV line, central venous catheters are small, flexible tubes. 

These tubes are inserted into the body very carefully - usually through the neck, upper chest, groin or arm - to provide necessary medical treatment to patients, and/or to allow ease of access to draw blood for regular medical testing.

The entry point of central lines into the body are covered by vascular access line dressings to protect each site from potentially harmful bacteria. 

When are central lines used? 

Central lines are used to administer treatment to patients in seconds, and are often used in intensive care units (ICUs) and oncology departments. 

Central lines are often given to patients who are receiving treatment for:

  • cancer (chemotherapy)
  • heart conditions
  • pain management
  • infection prevention and control
  • and more

Patients whose conditions require them to have medicine administered regularly over a long period of time, either as in-patients or out-patients, may also be given a central line connection that remains inserted for a year or more to make treatment easier.

Having a central line connection means that patients receive more immediate treatment, and are pricked by needles less often than they would be if regular IV connections into the hands or arms were necessary.

Why is it important to care for your central line? 

As with any medical intervention that requires a medical tool to be inserted beneath the skin, there is always risk of infections with central line catheters.

Hospital acquired (or healthcare associated) infections (HAIs) are the cause of approximately 99,000 deaths around the world. 

According to the National Library of Medicine, as many as 1 in 25 patients receiving care in hospitals are affected by HAIs. 

While developing a bloodstream infection in and of itself may not initially be concerning, patients with a central line - like an infant who is undergoing cardiac surgery for congenital heart disease - are already facing an illness, or diagnosis that is pushing their body to fight and function. 

When a patient with a central line faces a HAI, the consequences can be serious from a setback to receiving lifesaving treatment to life threatening developments like sepsis. 

There are ways to reduce the risk of infections, including insertion protocols, research-backed care standards and the use of innovative medical technology that is designed to reduce bacterial contamination to line sites and touch points while patients are receiving medical care in the hospital. 

How to care for your central line

Whether you’re at home or at the hospital, it is important to follow health and safety precautions that will protect your central line from exposure to potentially dangerous infections. Always follow the care guidelines provided by your medical team. 

Below, we have curated a short overview of recommendations from leading medical resources to help you plan for the care of your own, a loved one’s, or a patient’s central venous line. 

According to the Cincinnati Children’s Hospital, there are some simple steps you can take to avoid problems with your connection sites:

  • Make sure your hands are thoroughly cleaned or encased in sterile gloves before touching central line connection sites.
  • Always keep a clean, dry dressing over the central line site. 
    • When possible, use a gentle transparent dressing that does not hurt to be removed or replaced and allows full visibility for ease of site monitoring.
  • Follow all instructions for cleaning the caps, and use sterile equipment for flushing tubes.
    • (Note: if a line is hard to flush, don’t force it).
  • Avoid tugging or pulling on the connection site to avoid discomfort and pain. 

Daily care of central line sites

As indicated by Johns Hopkins Medicine, patients should not shower until after an incision site has healed, and it is best practice to keep the incision site dry. 

Use waterproof dressings to keep the site dry.

As recommended by the National Library of Medicine, you should find out everything you need to know about central line management before going home with your central line. 

Advanced Central Line Technology 

Patients living with a central line deserve to do so with the most comfort, ease and protection possible. 

Using the right technology can empower patients to live the highest quality life possible with less anxiety about their treatment. 

Care providers should look for:

  • IV dressings that contain effective broad-spectrum antimicrobials, such as chlorhexidine and silver
  • Dressings that exceed modern antimicrobial standards on gram positive and gram-negative bacteria and yeast commonly associated with Catheter Related Bloodstream Infections (CRBSIs)
  • Transparent dressing made with atraumatic silicone adhesives that make daily assessments simple and protect patients skin
  • Line-to-line connection barriers that maintain safe, fast access to hubs while limiting opportunity for error

Additional central line care resources and supports

If you’re a parent trying to learn more about central line to help care for your child, read Johns Hopkins All Children’s Hospital’s fact page about central line care.

Study this self-learning module provided by Fraser Health to learn more about central line care. 

If you’re in need of innovative medical products to help you care for your own, or a loved one’s central line connection, connect with Covalon today. 

Healthcare workers who are looking for ways to decrease CLABSIs on their units, consider using dual-antimicrobial dressings like IVClear with your patients. Request free samples so that you can experience the difference that our gentle products make to the healing journey. 

References

National Public Radio: “Health care employees are overworked and exhausted.” 

Cambridge Press: Continued increases in the incidence of healthcare-associated infection (HAI)...

National Library of Medicine: Peripheral Line Placement

National Library of Medicine: Central Venous Catheter

KidsHealth: Central Lines

Canadian Cancer Society

St. Luke’s

CDC: Frequently Asked Questions about Catheters

National Cancer Institute

Memorial Sloan Kettering Cancer Society

National Library of Medicine: Characteristics of Healthcare-Associated Infections Contributing to Unexpected In-Hospital Deaths

CDC: Intravascular Catheter-related Infection (BSI)

Johns Hopkins Medicine 

Cincinnati Children’s Hospital

National Library of Medicine: Care of a Central Line

National Library of Medicine: Central Line Management

Johns Hopkins All Children’s Hospital

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