What Is Tunneled Central Line (or) Dialysis Catheter?
A central venous line refers to a catheter inserted into a vein in the neck, providing direct access to the heart. These catheters come in various configurations and sizes to suit different medical needs and patient requirements.
Why is it done?
A central line is necessary when a patient needs medications given through their veins over an extended period of time. It is easier and less painful to have a central line placed than having to put a needle into a patient’s vein each time they need therapy. Central lines are preferred over traditional IV’s because they can stay in place longer, it is easier to draw blood from, and it allows for a wider range of medications to be administered.
How is it performed?
Typically, the patient is positioned lying on a bed during the central venous line insertion procedure. The skin around the intended site is thoroughly cleaned, and a local numbing medicine (anesthetic) is injected to minimize discomfort. Additionally, an intravenous (IV) medication cocktail is administered to induce relaxation and maintain the patient’s comfort throughout the procedure.
A needle is then carefully inserted through the skin and into a vein in the neck, typically targeting the right internal jugular vein, establishing a small tunnel. Subsequently, a wire is threaded through this tunnel, with fluoroscopy employed to monitor its precise positioning and ensure it is in the correct location.
Following this, a hollow sheath is advanced over the wire, facilitating the insertion of the central line. Once the line is in place, its position is once again verified using fluoroscopic imaging.
Finally, the sheath is removed, and the central line is secured in position with sutures and properly bandaged to prevent any displacement or infection.
What Should I Expect?
In preparation for your procedure, you might be instructed to withhold specific medications. Throughout the procedure, you may be asked to briefly hold your breath or adjust the position of your head to facilitate venous access. While the central line is being inserted, you may encounter moments of discomfort or pressure in your neck. These sensations are typically transient and can be managed effectively by the medical team.
Recovery
Typically, any symptoms you encounter during or after the procedure should subside within 1-2 hours. It is advisable to refrain from engaging in strenuous activities for the next 48 hours. However, if you notice a significant increase in pain following the procedure, it is essential to seek immediate medical attention for further evaluation and appropriate management
Possible Risks/Complications
While typically perceived as a low-risk procedure, complications of central line placement may include bleeding at the puncture site, infection, inadvertent puncture of an artery, formation of a hematoma, and the development of a pneumothorax.