WHAT YOU NEED TO KNOW:

What do I need to know about a midline catheter? A midline catheter is an IV placed into a vein in your child's upper arm. Your child's catheter may have multiple ports. Ports are tubes where medicine can be injected. A midline catheter can be kept in place for several weeks or months. Your child may need a midline catheter to get medicine or fluids. His catheter may also be used to remove blood for tests.

How is a midline catheter inserted?

• Your child's healthcare provider will place a tight band around his arm. This helps his healthcare provider see his veins. Your child's healthcare provider will insert a needle through your child's skin and into his vein. A catheter will be guided over the needle and into his vein. Your child's healthcare provider may use ultrasound or x-ray pictures to place the catheter correctly.
  
  
• The needle will be removed, and the catheter will be left in your child's vein. Healthcare providers may secure the catheter to his skin with tape or stitches. A bandage will be placed over his catheter.

How do I change the bandage and clean my child's skin? Your child's healthcare provider will tell you how often to change his bandage. Change the bandage any time it becomes wet, dirty, or moves out of place. Keep your child's catheter covered with a bandage at all times. You may need another person to help you change the bandage. Do the following to change your child's bandage:

• Wash your hands with soap and water or an alcohol-based hand rub. Put on clean gloves.
  
  
• Hold the end of your child's catheter so it does not move. Slowly remove the bandage by pulling it towards the area where his catheter is inserted (insertion site). Do not pull the bandage away from the insertion site. This can pull out your child's catheter.
  
  
• If your child's catheter is secured with a device, gently remove it as directed.
  
  
• Wipe the insertion site with a cleaning solution as directed. Wipe the skin around the insertion site with a cleaning solution as directed. Start closest to the insertion site and move outward in circles.
  
  
• Wipe the tubing that comes out of your child's skin with a cleaning solution as directed.
  
  
• Place a new securement device around your child's catheter as directed.
  
  
• Apply a bandage as directed. If the bandage is clear, make sure you can see the insertion site.

How do I care for the caps and tubing?

• Clean the injection cap before and after each use. Wash your hands and put on gloves before you clean each injection cap. Hold the catheter above the cap with 1 hand. Scrub the injection cap with an alcohol pad for 15 seconds.
  
  
• Change the injection caps every 3 to 7 days or as directed. Wash your hands and put on gloves before you change the caps. If there are clamps, close the clamps on each port of your child's catheter. Twist the caps to remove them from the end of each port. Scrub the end of each port with an alcohol pad for 15 seconds. Place a new cap on the end of each port.
  
  
• Change and clean the medicine tubing as directed. You may need to attach extra tubing to your child's catheter to give him medicine. Ask your child's healthcare provider how often to change the medicine tubing. Wash your hands and put on gloves before you touch your child's medicine tubing. Wipe the end of the tubing with an alcohol wipe before you attach it the injection cap. Always place a cap over the end of medicine tubing when it is not being used.

How do I flush my child's catheter? Your child's healthcare provider will tell you how often to flush his catheter. His healthcare provider will also tell you how much saline to flush his catheter with. If your child's catheter has multiple ports, you will need to flush each one. Do the following to flush your child's catheter:

• Wash your hands with soap and water or an alcohol-based hand rub. Put on clean gloves.
  
  
• Scrub the injection cap with an alcohol pad for 15 seconds.
  
  
• Attach the saline syringe to the injection cap.
  
  
• Slowly push on the plunger of the syringe to flush your child's catheter. Do not force the saline into his catheter. This could damage the catheter or his vein. Call your child's healthcare provider if you cannot flush his catheter.
  
  
• Throw away the syringe as directed. Clean the injection cap with an alcohol pad for 15 seconds.

What can I do to prevent a bloodstream infection?

• Wash your hands and your child's hands often. Wash your hands before and after you touch your child's catheter. Use soap and water or an alcohol-based hand rub. Tell others to wash their hands before and after they visit. This will decrease germs in your home.
  
  
• Limit contact with your child's catheter. Tell your child not to touch his catheter. You should only touch your child's catheter when you need to give him medicine or clean it. Do not let others touch your child's catheter or medicine tubing.
  
  
• Keep your child's tubing clamped when not in use. This will prevent air and water from getting into your child's catheter.
  
  
• Do not let your child swim or take a bath. These actions can cause germs to get into your child's catheter. Your child can shower or take a sponge bath.
  
  
• Cover your child's catheter with a waterproof cover before he showers. Ask his healthcare provider where to buy a waterproof cover. He may instead tell you to place a plastic bag or wrap over your child's catheter. Help your child keep the catheter out of the water as much as possible. Change the bandage if it gets wet.
  
  
• Check your child's catheter every day for signs of infection. Look for redness, swelling, pus, or fluid. Report any pain at the insertion site or signs of infection to your child's healthcare provider.

What can I do to care for my child?

• Ask your child's healthcare provider which activities are safe for him. Do not let your child lift anything heavier than 5 pounds. Do not let your child play sports unless his healthcare says it is okay.
  
  
• Give your child plenty of liquids. Liquids will help prevent dehydration and blood clots. Ask your child's healthcare provider how much liquid to give him each day and which liquids are best for him.
  
  
• Tell your child's healthcare providers that he has a catheter. Tell them not to do, IVs, blood draws, and blood pressure readings in his arm with the catheter. Do not allow flu shots or vaccinations in his arm with the catheter.

Call 911 for any of the following:

• Your child feels lightheaded, short of breath, and has chest pain.
  
  
• Your child coughs up blood.
  
  
• Your child has trouble breathing.

When should I seek immediate care?

• Blood soaks through your child's bandage.
  
  
• Your child's arm is warm, painful, and larger than usual.
  
  
• Your child has trouble moving his arm.
  
  
• Your child's catheter falls out.

When should I contact my child's healthcare provider?

• Your child has a fever.
  
  
• Your child has swelling, redness, pain, or pus where the catheter was inserted.
  
  
• You cannot flush your child's catheter, or your child says he has pain when you flush his catheter.
  
  
• You see a hole or crack in the tubing of your child's catheter.
  
  
• You see fluid leaking from the insertion site.
  
  
• You run out of supplies to care for your child's catheter.
  
  
• You have questions or concerns about your child's condition or care.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.