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17
WHAT THE C?!? /// CHAPTER 11
Having a central line eliminates the need for repeated needles to start an IV line or to
draw blood. And central lines can stay in for many months, even years, until the end of
your cancer treatment, when they can be removed.
So, it's worth it! How do central lines work?
All central lines work on the same general principle. A small catheter (a thin tube through which liquid runs) is surgically
implanted (under anesthetic) and then fed into the superior vena cava - a major vein that dumps into the right part of your
heart. From there, it either exits the skin as EXTERNAL tubing (a central line) or ends in a small device - called a port -
IMPLANTED under your chest skin.
External Central lines:
The most common is the Hickman Line (named after the
person who developed them). From the tip in your vena
cava (a large vein carrying deoxygenated blood into the
heart), the other end of the catheter is " tunneled " under
your skin for a short distance, where it exits through
another small incision at a spot near your breastbone. The
catheter branches out into a couple of smaller tubes called
lumens, which hang on the outside of your body. A sterile
dressing covers the exit site at all times.
The advantage of this type of line is the number of lumens;
you can have several different types of fluids or meds
being infused at the same time through different lumens.
Sometimes, if the drugs are compatible, you might have
two different drugs going through the same lumen at the
same time.
A Peripherally Inserted Central Catheter (PICC) works
along the same principle, with the tip ending in your
superior vena cava, but the insertion point and exit of
the catheter lumens is in your arm not your chest. These
can have one or two lumens. Often, they're used when
treatment is short term or until a more durable central line
can be surgically implanted.
PICC lines are simpler and less invasive than other central
catheters and can be inserted by a nurse.
" A central line is a new way
of living life. Be mindful of it,
as it is your access to easier
treatment. " Ports " are delicate
and should be treated as such! "
- Griffin Ganninger FWAYA PAC
Subcutaneous (under the skin)
implantable ports
This type of line is usually referred to as a medi-port or
port-a-cath. Unlike a Hickman line, an implantable port
is completely under the skin. This type of catheter is
surgically implanted, usually in your chest, but some people
also have them in their arms. It is usually done with a
general anesthetic. One end of the catheter is fed into a
large vein leading directly into your heart. The other end is
attached to a small chamber called a portal. The portal is
made of metal and/or plastic with a rubber top that seals
it and is placed under your skin. Some devices even have
two rubber areas so you can have two access lumens at a
time (decreasing the chance of needing a peripheral IV in
your arm). You will feel a small bump under your skin where
the port has been placed. When you need to use your port,
it is accessed with a special needle (a Huber needle) that
has a tube attached to it. Your meds or whatever will flow
through the needle, into the catheter and then into your
bloodstream. The needle and short tube will stay in for the
length of your infusion or your hospitalization and then will
be removed before you go home.
After a while, the skin over your port becomes tougher and
less sensitive, so you won't necessarily feel it every time it
is accessed. However, especially at the start, you can use
an anesthetic cream like EMLA to numb the area before it
is accessed (EMLA Cream works by numbing the surface
of the skin for a short time. It is put on the skin before
certain medical procedures). You will need to remember
to do this before you get to the clinic or hospital, so it has
time to work and you don't delay getting your bloodwork or
infusion.
https://fwaya.org/

What Do I Do Now?

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