Thank you everyone for your prayers. Taryn did awesome today when the put the central line in. They gave her more pain meds, started the procedure and she started saturating in the 90’s! This child is SO darn amazing! Well God is actually the amazing one, but still she handled like it was no big deal. After it was over she started sat-ing in the mid to high 80’s. Ben and I were able to leave the hospital finally feeling like she was feeling a little better. We finally felt a little relief.
This procedure will not get her better but it gives them an access point to administer her meds, so she doesn’t have to 4 IV’s in her body.
What they put in is called a Broviac catheter.
Her is some info and a picture:
WHAT ARE BROVIAC® CATHETERS AND HICKMAN® CATHETERS?
Broviac ® catheters and HICKMAN® catheters are similar to a PICC line. They both allow a soft special type of rubber (silicone) IV catheter to be placed in your child without the need for repeated peripheral IV sticks. A BROVIAC® catheter, however, is placed directly into a central vein, usually in the neck, upper chest or groin. The catheter proceeds to a position just above the heart. In general, a BROVIAC® catheter is tunneled under the skin and brought out on the chest or thigh away from the site where it enters the vein. Theoretically, this prevents bacteria from gaining access to the central portion of the catheter. Finally, BROVIAC® catheters contain a “cuff” which is buried under the skin. Your child’s tissues will grow into this “cuff” and allow the catheter to become more stable, which will reduce the chance of it becoming pulled out.
TUNNELED CENTRAL VENOUS CATHETER
HICKMAN® catheters and BROVIAC® catheters are tunneled central venous catheters. The catheter is tunneled under the skin and placed in one of the veins just under the collarbone. The catheter is long enough to reach the large vein that enters the heart. This vein is called the superior vena cava (VEE.na CAVE.uh). The purpose of tunneling the catheter under the skin is to help prevent infection. A small cuff is located around the catheter about one inch inside the place where the tube enters your child’s skin. Skin grows into this cuff and keeps the catheter in place. The cuff also acts as a barrier to infection.
Tunneled catheters have 1, 2, or 3 outside openings. These openings are used for many kinds of medical treatments (fluids, medicines, blood samples, etc.). With a catheter, your child does not need to receive a needle each time one of these procedures must be done.
WHY DOES YOUR CHILD NEED A TUNNELED CATHETER?
Some children have IV needs that exceed what a PICC can do. Some may need a catheter for a prolonged period of time – generally greater than 3 months. Others may have a need for extensive blood draws for laboratory tests that may exceed what a PICC can do. Finally, some children may not have large enough peripheral veins to allow for a PICC line. It may be used for chemotherapy, IV medications, IV nutrition, and obtaining blood samples.
If the tunneled catheter is injected (flushed) regularly with an anti-clotting medicine, it does not need to be attached to an IV bag all the time. This allows your child to be mobile. Your child may have the tunneled line only during the hospital stay, or he or she may go home with one.
HOW IS A BROVIAC® CATHETER PLACED?
Unlike a PICC line, BROVIAC® catheters are generally placed in an operating room setting. A surgeon will place such a line. Your child will most likely undergo a general anesthetic (completely asleep) when the BROVIAC® catheter is inserted. This is important, as there is more pain and discomfort when this catheter is placed. Additionally, the surgeon will need to use X-rays (fluoroscopy) while placing the line – something which can’t be done at the bedside.
In general, a prescription for a pain medication may be given for your child (often Tylenol (acetaminophen) with Codeine elixir or tablets). This prescription pain medication can be used for the first couple of days until the pain subsides. Importantly, do not mix this Tylenol with Codeine with regular Tylenol as this could be harmful to your child). The doctor makes a small opening in the mid-chest area. Another opening is made where the catheter will enter the vein. A tunnel is formed under the skin between the two openings.
The catheter is passed through this tunnel and then gently threaded into the vein. Your child will get a chest X-ray to make sure the catheter is in the proper location.
Small bandage tapes, called Steri-strips are placed over the openings. The catheter may also have a few stitches to hold it in place.