Clinics

Vascular Access Service

What is the Vascular Access Service?

The Vascular Access Service team works with children and teens who need medicine put directly into their vein. Our goal is to minimize discomfort while making sure you and your child feel empowered and knowledgeable about intravenous (IV) therapy during your child's hospital stay or at home.

Vascular Access Service helps put medicine and fluids into your child’s IV and draws blood samples from your child’s IV, including PICC (peripherally inserted central catheter) line and central lines. We can also help if the line needs to be fixed.

If your child needs to go home with a central line, we will teach you how to take care of it in partnership with your home care company.

Why does my child need an IV, central line or access port?

Some medicines can't be taken by mouth or by injection and need to be put directly into the vein
Your child may not be able to take the medicine by mouth or injection
To draw blood

Who does the Vascular Access Service treat?

Some of the clinics the Vascular Access Service team commonly partners with are:

Cancer and Blood Disorders Center
Dialysis
Gastroenterology and Hepatology (liver and intestinal failure)
General Surgery
Heart Center
Infectious Diseases and Virology
Neonatology

What services do we offer?

Peripheral intravenous (PIV)

A PIV is placed at the bedside by a nurse. The nurse can use numbing cream or other strategies to reduce the pain of the needle poke for your child.

This type of IV is usually put on either a hand or arm, and it can also be put on a foot or leg if your child doesn't walk. After the IV is placed in the vein, a small flexible tube (like spaghetti) stays in the vein. This should not be painful for the child.

This type of IV usually stays in for a couple of days. These are used when your child is in the hospital but occasionally can be used at home (PDF).

Central lines

A central line is a small tube that delivers medicine and fluids to your child into a large vein near their heart. Your child will usually go to the operating room or to interventional radiology where a trained provider will put in the line. It can sometimes be placed at the bedside. For details on the steps that happen when your child needs a central line, see the Central Line Road Map (PDF).

Keeping the line clean and cared for is very important to prevent infection. Your care team ensures this line doesn’t get infected. If your child leaves the hospital with a central line, we will teach you how to take care of it before your child goes home.

Broviac single lumen central line catheter

A single lumen tunneled central venous catheter (Broviac central line) is a type of central line.

Broviac Single Lumen Central Line Catheter (PDF) (Dari) (Spanish) (Somali) (Simplified Chinese) (Vietnamese)
Hickman double lumen central venous catheter

A double lumen tunneled central venous catheter (Hickman central line) is a type of central line.

Double Lumen Central Venous Catheter (PDF) (Marshallese) (Spanish) (Portuguese) (Somali) (Simplified Chinese) (Vietnamese)
Implanted port (port-a-cath)

An implanted port is put under your child’s skin and is attached to the catheter that goes to the big vessel near their heart. To access the implanted port, a nurse will poke a needle through the skin and into the implanted port. It is then ready to use for IV medicines or blood draws.

If your child will have time between treatments, they may not need to have their port accessed. When the clear dressing and needle are removed, the port is fully under the skin. This helps reduce the chance of infection and allows your child to do activities like showering or bathing without extra steps to care for the line.

Implanted Port (Port-a-Cath) (PDF) (Spanish) (Simplified Chinese) (Somali) (Vietnamese)
Peripherally inserted central catheter (PICC)

A peripherally inserted central catheter (PICC) is a type of central line. The catheter usually exits the body at the upper arm. In young children, the catheter will sometimes exit the body at the leg, near the diaper area (groin) or on top of the head (scalp).

Peripherally Inserted Central Catheter (PICC) (PDF) (Amharic) (Spanish) (Somali) (Simplified Chinese) (Vietnamese)
Tunneled central venous catheter used for apheresis

A central venous catheter is a special type of double central line.

The tubes usually exit the body at the upper chest. Apheresis means taking your child’s blood out from one of the lumens of the catheter and then passing it through a machine that separates part of the blood and returns it back through the other lumen of the catheter.

Tunneled Central Venous Catheter Used for Apheresis (Apheresis Line) (PDF) (Spanish) (Somali) (Simplified Chinese) (Vietnamese)
Temporary central venous catheter (central line)

A temporary central venous catheter is a type of central line. The tube usually exits the body on the side of the neck, the abdomen or the groin.

Temporary Central Venous Catheter (PDF) (Spanish) (Somali) (Simplified Chinese) (Vietnamese)

Caring for your child’s central line

Most children with a central line leave the hospital with it at some point during their treatment. While caring for their central line may seem intimidating at first, we have confidence that practice with your child's care team and use of the resources below will help you feel ready to do this with your child.

Changing the cap

How to Change the Cap on a Central Line (PDF)
Videos:
- How to Change the Cap on Your Child's Central Line
- Cómo cambiar la tapa de la línea central (Spanish)
- Sida loo beddelo Furka Tuubada Faleebada xabadka ee Ilmahaaga (Somali)
- 如何给您孩子更换中央静脉导管盖 (Mandarin)
- 如何给您孩子更换中央静脉导管盖 (Cantonese)
- Cách thay nắp trên đường truyền trung tâm của con quý vị (Vietnamese)

How to flush the line

How to Flush a Central Line (PDF)
Videos:
- How to Flush Your Child's Central Line
- Cómo irrigar la vía intravenosa central (Spanish)
- Sida Loo Biyo-raaciyo Tuubada Katiitarka Dhuunta ee Ilmahaaga (Somali)
- 如何冲洗您孩子的中心静脉导管 (Mandarin)
- 如何冲洗您孩子的中心静脉导管 (Cantonese)
- Cách thụt rửa đường truyền trung tâm của con quý vị (Vietnamese)

Changing the dressing

Treat infiltration or extravasation

An infiltration or extravasation happens if medicines given through PIV leak into the surrounding tissues and cause an injury.

To treat this, a nurse will need to look at it soon. If needed, we will inject medicine around the area to help it heal and watch it over time. Often a warm compress and elevation above the heart level are all that are needed to heal the area. Infiltrations or extravasations usually get better within a couple of days.

Learn more about infiltration or extravasation (PDF) (Spanish).

Central line removal

When your child no longer needs IV medicines or blood draws, we can take the PICC and temporary line out at the bedside. Removing the line doesn’t hurt.

If your child has another type of line, like an implanted port or central line, we will remove it in the operating room or interventional radiology when it is no longer needed. Learn more about Care After PICC Line Removal (PDF) (Spanish).

Treating problems with IV lines

If something happens to your child’s line, whether it’s not working properly, gets clogged, breaks or there’s another issue, the Vascular Access Service team will help. If there is a problem with your child’s line, please call your home care company and let your care team know.