A venous line is an IV that is placed in a large vein. The name of the line depends on the vein in which it is placed. A commonly used vein to introduce this line is the subclavian vein, or subclavian line.
The subclavian line has two or three different entrance gates. This makes it possible (if necessary) to administer two or three different types of infusion fluids at the same time. Your doctor will determine which catheter will be placed for you.
PAY ATTENTION!
You must prepare for this treatment. Therefore, read this information carefully at least ONE DAY before the treatment! It is important that you follow these instructions carefully. Otherwise, the investigation may not proceed.
Why a venous line?
Your treatment requires that you receive medication, chemotherapy or nutrition (TPV) through the blood vessels. If a long-term administration is necessary, a subclavian line can be used. This ensures constant access to the bloodstream. The blood vessel does not have to be punctured again and again.
Preparation
Hospital admission
For the insertion of a central venous catheter, you will be admitted to the hospital in the Day Treatment Department or in one of the other nursing departments. If you must stay overnight, bring nightwear and toiletries. You will receive a letter in advance with information about the admission.
If you have already been admitted to hospital, the appointment for the treatment will be passed on to the nursing department by telephone. The treatment itself takes place during the day in the Radiology department.
Food and drink
You do not need to be fasting for this treatment. So you can just eat and drink.
Do you use blood-thinning medicines or do you have a blood clotting disorder?
Then it is important that the doctor who requests this examination/treatment knows this. Your doctor will tell you whether you should stop taking the blood thinners or whether you can continue taking them.
What happens during the treatment?
You will be given a surgical gown and taken to the Radiology Department in a bed. The catheter is inserted in the intervention room of the Radiology Department.
During insertion, you will lie on your back on a bed, with your arms at your sides. You will be connected to a surveillance monitor.
Insertion is done in a sterile manner. Sterile means ‘free from germs’. The employees who insert the catheter therefore wear an operating gown, mask, cap and sterile gloves. During the treatment you will lie under sterile cloths, your head will also be (largely) under these cloths.
An ultrasound machine is used to locate the vein in which the subclavian line is placed. First, the insertion site is numbed. This can give you an unpleasant feeling. Moving the catheter into your blood vessel is not painful. You usually feel little or nothing of it.
During insertion, X-rays are used to check whether the catheter is in the right place. The catheter is sutured to the skin and covered with a clear plaster called a Tegaderm.
After the treatment you will be taken back to the nursing ward in your bed.
Care of the subclavian line
The nurse on the ward knows how to care for the subclavian line. The insertion opening is checked daily by the nurse for signs of infection. The Tegaderm is replaced weekly (or sooner if necessary). You
can shower with a subclavian line if the line is covered with Tegaderm. You are not allowed to bathe; this increases the risk of infections.
Are there any side effects or risks?
Every medical treatment has risks and possible complications. The most common are:
- A haemorrhage. This is checked in the nursing ward;
- A collapsed lung (pneumothorax). Because the line is inserted under ultrasound guidance, the chance of a collapsed lung is very small;
- An infection (lineage sepsis). There is a possibility that the catheter will become infected.
- The insertion opening is checked daily. As soon as the catheter is no longer needed, it is removed.
When should you contact us?
Usually the subclavian artery line is removed before you go back home. In a few cases, a patient goes home with a subclavian line. If you go home with the subclavian line, contact the hospital:
In case of a (possible) infection around the insertion opening.
- You will notice this by redness, swelling, warmth, pain, fluid (pus);
- In case of a burst in the catheter;
- If the sealing cap comes off.
Contact us directly (also at night!) at:
signs of a thrombosis (blood clot in the vein), namely arm or shoulder pain, swelling, redness;
shortness of breath, cough, chest pain and loss of consciousness;
fever (a temperature of 38.5°C or higher).
During office hours you can call your attending physician, outside office hours you can call the Emergency Department: telephone number 745-0000 (ask for Emergency)
