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Michelle Barford

               Many times, those who are going to have a line placed for the administration of home parenteral (IV) nutrition (HPN) do not know what to ask, or don’t have time before the line will be placed to consider what their questions might be. Too often the line placement is done due to an emergency, and the only things you want to know are: (1) How is this going to affect my situation?; (2) How long will I need to be in the hospital?; and (3) What more do I need to learn?  


You are told you need to have a central line placed and what type of line you’re going to have, and arrangements may have already been made for the placement, which is often done in interventional radiology (IR). This can be at a hospital or a physician’s office that has its own IR department. It can also be done in the operating room (OR). 

When you have a central line placed, a number of considerations need to be made beforehand. These include the type of line and the location of the exit site. Other considerations include how active you are and whether you need to have more than just HPN infused. Another consideration should be whether the line is repairable, or if it will have to be replaced if it fractures or becomes occluded.


Whether HPN is new to you or you are “just” getting a new line placed, there are certain parts of this scenario that you need to beware of:

1. If there is enough time, you should be able to have a voice in all of the considerations mentioned above.

2. There are tunneled central lines that can be repaired. This means that if they fracture or break, they may be able to be repaired instead of being replaced. This is so much better for you because (a) repairs to a central line may be done in your doctor’s office or the emergency department (ED); and (b) when you have a central line removed, the vein may be damaged or can collapse, making it unusable in the future, which will limit your options for future line placement. You should discuss your central line options with your health-care provider.

3. If your central line can be repaired, your infusion company may be able to provide a repair kit for you. There may be an extra charge for you if it isn’t covered in the “per diem” they receive for your HPN supplies. You can appeal this decision if there is an out-of-pocket expense.

4. There are several different kinds and brands of central lines available, including Broviacs, Hickmans, Groshongs, PICCs, and ports. One thing they all have in common is the need for you to obtain additional knowledge beyond what’s offered at the doctor’s office and hospital.

               Remember that you will have your hands full dealing with getting a central line placed and definitely will need the support of family and friends to assist you in learning all there is to know about your new line. Organizations like Oley can assist you and your caregiver in obtaining information about HPN, your central line, and the care of your central line. Even if you’ve had one before, receiving a new line will require you to reacquaint yourself with what the aftercare of the new line is, so you won’t overlook something important!

 

Most important of all, know that YOU ARE NOT ALONE!



LifelineLetter, November/December 2018

This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.

 

Updated in 2015 with a generous grant from Shire, Inc. 

 

This website was updated in 2015 with a generous grant from Shire, Inc. This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.
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