This information will teach you about the placement and care of your central venous catheter (CVC).
A CVC is placed in a large vein above your collarbone (see Figure 1). There are many different types of catheters (thin, flexible tubes) and your doctor will decide which kind is best for you.
All devices have 1 central catheter that enters your body. On the outside, the catheter may divide into 1, 2, or 3 lumens. Each lumen has a clamp, a needleless connector, and a disinfection cap on the end.
A CVC can be used to take blood samples, as well as give:
- Chemotherapy and other medications
- Blood transfusions
- Intravenous (IV) nutrition
The advantages of having a catheter are:
- You won’t need as many needle sticks.
- It can stay in your body for as long as a few years and be removed when it is no longer needed.
Your nurse will teach you how to care for your catheter. You can have a caregiver, family member, or friend learn with you. You will learn how to use sterile technique to change your dressing. This will minimize your risk for infection. You will also learn how to change your needleless connectors and disinfection caps (SwabCaps®), as well as flush your catheter using a syringe with normal saline solution. You must flush your catheter to keep blood clots from forming inside of it. Once a week, you will change the needleless connectors, disinfection caps, and your dressing, as well as flush your catheter. You may want to mark your calendar to help you remember to do so. After you go home, use this information to help you remember the steps to care for your catheter.
Before Your Procedure
You may need to stop taking some of your medications before your procedure. Talk with your doctor about which medications are safe for you. We have included some common examples below.
- If you take medication to thin your blood, ask your doctor what to do. Some examples are aspirin, warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), cilostazol (Pletal®), prasugrel (Effient®), dabigatran (Pradaxa®), ribaroxaban (Xarelto®), apixaban (Eliquis®), and ticlopidine (Ticlid®). These medications can be used to treat blood clots or to prevent a heart attack or stroke.
- If you take insulin or other medications for diabetes, you may need to change the dose before your procedure. Ask the doctor who prescribes your diabetes medication what you should do the morning of your procedure.
- Please review the information in Common Medications Containing Aspirin and Other Nonsteroidal Anti-Inflammatory Drugs for examples of what not to take and what to take instead.
- Do not take vitamin E for 10 days before your procedure, or as directed by your doctor.
You must have someone 18 years or older take you home after your procedure. If you don’t have anyone, call one of the agencies below. They will provide someone to accompany you home, however there is usually a charge for this service and you will also need to provide transportation.
In New York:
Partners in Care 888-735-8913
Prime Care 212-944-0244
In New Jersey:
Caring People 877-227-4649
If you develop any illness (fever, cold, sore throat, or flu) before your procedure, please call a nurse in Interventional Radiology at 212-639-2236. A nurse is available Monday through Friday, 9:00 am to 5:00 pm. After hours, during the weekend, and on holidays, call 212-639-2000 and ask for the Interventional Radiology fellow on call.
A staff member from the Interventional Radiology office will call you 2 business days before your procedure. He or she will tell you what time you should arrive at the hospital for your procedure. If you are scheduled for your procedure on a Monday, you will be called on the Thursday before. If you don’t receive a call by noon the business day before your procedure, please call 212-639-5051.
If you need to cancel your procedure for any reason, please call the doctor who scheduled it for you.Back to top
The Day of Your Procedure
- Do not eat or drink anything after midnight the night before your procedure. This includes water, gum, and hard candy.
- Take your medications the morning of your procedure as instructed by your doctor. Take them with a few sips of water.
- Do not apply cream or petroleum jelly (Vaseline®). You can use deodorant and light moisturizers.
- Remove any jewelry, including body piercings.
- Leave all valuables, such as credit cards and jewelry, at home.
- If you wear contact lenses, if possible, wear your glasses instead. If you don’t have glasses, please bring a case for your contacts.
- A list of the medications you take at home.
- Medications for breathing problems (such as inhalers), medications for chest pain, or both.
- A case for your glasses or contacts.
- Your Health Care Proxy form, if you have completed one.
- If you use a CPAP or BiPAP machine to sleep at night, please bring your machine with you, if possible. If you can’t bring your machine with you, we will give you one to use while you are in the hospital.
- Memorial Hospital
1275 York Avenue (between East 67th and East 68th Streets), New York, NY 10065
Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital. If you have questions about prices, call 212- 639-2338.
There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.
When you arrive at Memorial Hospital, take the M elevator to the 2nd floor. Enter through the glass doors and check in at the desk.
- Memorial Sloan Kettering West Harrison
500 Westchester Avenue, West Harrison, NY 10604
When you enter the building, check in at the reception desk and they will direct you to Interventional Radiology
Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having procedures on the same day.Back to top
During Your Procedure
Two areas of your body will be numbed with a local anesthetic. A small incision (surgical cut) will be made at the base of your neck. A second small incision will be made on your chest, under your collarbone. The catheter will be inserted through the second incision, tunneled under your skin to the first incision, and threaded into your vein.
The incision at the base of your neck will be stitched closed. The stitches will be absorbed and will not need to be removed. Your catheter will be stitched to your skin at the point where it exits your body (exit site) so that it will stay in place.Back to top
After Your Procedure
You may have some discomfort at your incision sites and along the CVC tunnel. Ask your nurse for medication to relieve your pain.
Your dressings need to be kept dry for 24 hours following your procedure. You must change your dressings 24 hours after your procedure. Two days after your procedure, you can remove the dressing that covers the small incision at the base of your neck. After that, you can leave it open to the air.
The strips of adhesive tape that cover this incision should be left in place until they start to peel off. This should happen about 3 to 5 days after your procedure. Your catheter exit site will still need to be covered with a special dressing. This dressing will protect the stitches at the site. These stitches keep your catheter in place until the cuff on the catheter becomes anchored in the tunnel under your skin.
Your catheter will not interfere with your usual activities, such as household tasks, job responsibilities, and exercise. However, we suggest that you avoid contact sports, such as football and soccer, while your catheter is in place.
Prepare the following emergency kit and keep it with you at all times:
- 1 toothless clamp
- 1 dressing change kit
- Your doctor’s office and emergency telephone numbers
Changing Your Dressing, Needleless Connectors, and Disinfection Caps
- Do not change your dressing, needleless connectors, or disinfection caps in the bathroom after a shower. The steam from a shower can create a moist environment under your dressing and affect the adhesive. Make sure you change your dressing, needleless connectors, and disinfection caps on a clean, flat surface.
- You will see the folded Map for Dressing Change: CVC at the end of this resource. Use it to follow the step-by-step instructions for changing your dressing. This is when you will use sterile technique. You will not be able to touch the booklet then because that would break sterile technique. Open the map and spread it out where you can see it.
- You will use a Tegaderm CHG dressing to cover your exit site unless your doctor or nurse gives you another dressing to use. Change your dressing once a week, as long as it stays dry, intact, and clean. Change it on the day you change your needleless connectors and disinfection caps and flush your catheter. You may need to change it more often if it becomes moist, soiled, or peels away from the skin.
- If the Tegaderm CHG gel pad becomes swollen, change your dressing. You can test the gel pad by applying pressure to it with your index (pointer) finger. If you see an indent, the gel pad is swollen and your dressing should be changed. This can happen if there is a lot of sweat under your dressing.
- If you have problems with your skin, such as irritability or sensitivity, your nurse may suggest a different type of dressing. In that case, you may need to change it more often than once a week. No matter which dressing you are using, always change it right away if it starts to come off or gets wet. Do not just put another dressing or more tape over it.
- For more information, you can watch How to Change the Dressing, Needleless Connectors and Disinfection Caps on your Central Venous Catheter.