WARNING: The information in this section is meant as a general guide to help parents and caregivers with common issues and is not intended to replace the care provided by your child’s healthcare team. 

Discuss your child’s unique needs with the healthcare team, including WHO and WHEN to contact when problems arise.

 

Redness, heat, swelling or tenderness or pain at the catheter entry site

Extended redness or itching of the skin under dressing

Cord-like sensation of the vein where the catheter is inserted (may be hard, red or tender to touch)

One or more of these symptoms: burning or pain at the entrance site of the catheter, cold skin around the entrance site of the catheter, swelling of the arm (PICC line), swelling around the catheter site, leakage at catheter entry site, change in skin color (whiteness or redness) around the catheter entry site

For those with an implantable chamber catheter (eg, Port-a-Cath®): pain or swelling at the site of insertion of the reservoir during the administration of the solution or irrigation

Blood leaking at catheter insertion site

Protective dressing is wet or damp due to leakage of blood, pus or other discharge

Dressing is falling off, loose, punctured or torn

Presence of blood in catheter tubing

More residual solution than usual in the bag at the end of administration

More air bubbles than usual or presence of particles in the bag, whether the additives have already been added or not

Re-separation of the solution (before or during administration) after mixing the contents of the two chambers

Ambulatory infusion pump alarms

Resistance or inability to irrigate (flush) the catheter

Inadvertent disconnection of connector without needle or pump tubing

Broken (leaking) catheter or malfunctioning equipment

External displacement of the catheter (part of the catheter outside the vein shorter or longer than usual or catheter completely removed from the vein) with or without: pain in the ear, neck or shoulder on the side of the catheter, swelling in the neck, unusual sound heard by your child on the catheter side during flushing of the catheter or administration of the medication

Unusual sound heard by your child on the catheter side during irrigation with or without: pain in the ear, throat pain

Particular odor or a strange taste reported by your child during catheter irrigation

One or more of these symptoms: nausea, vomiting, headache, blurred vision, cold sweats, pallor, tiredness or irritability, seizures

One or more of these symptoms: headache, nausea, increased thirst, weakness, agitation, irritability, increased urination

One or both of these symptoms: dry skin, dry mouth, significant thirst, weakness, dizziness, decreased urination

One or more of these symptoms: faster breathing, difficulty breathing, swelling especially in the legs/feet or around the eyes, decreased urination, unexpected rapid weight gain

Fever with or without general malaise: ≥ 38⁰C rectal or ≥ 37.5⁰C buccal or ≥ 37.5⁰C armpit

One or more of these symptoms: swelling of the arm or side where the catheter is located, underarm pain in the arm where the catheter is located, swelling of the neck and face

 

For specific advice on your child or any other questions, do not hesitate to contact your child’s healthcare team.

When to consult your healthcare team

Intravenous catheter

  • The catheter entry site is red, swollen, hot or painful.
  • There is redness or itching of the skin under the dressing.
  • There is, redness, sensitivity or a cord-like feeling along the vein where the catheter is inserted.
  • The skin is cold around the entrance site of the catheter and your child complains about burning or pain at this location; there is swelling of the arm.
  • Swelling of the arm (PICC line).
  • Child with an implantable chamber catheter (eg, Port-a-Cath®): pain or swelling at the site of insertion of the reservoir during the administration of the solution or irrigation.
  • There is bleeding or other leakage at the entrance site of the catheter.
  • The color of the skin is pale or red around the entrance site of the catheter.
  • Irrigation/flushing of the catheter is difficult or impossible.
  • The length of the external portion of the catheter has changed or the catheter is partially or completely removed from the vein.
  • The catheter is broken.
  • Your child hears an unusual sound during irrigation of the catheter.

Equipment for administering the nutrient solution

  • There is more residual solution than usual in the bag at the end of administration.
  • The bag contains more air bubbles than usual or particles, whether the additives have already been added or not.
  • The solution is separated (before or during administration) after mixing the contents of both chambers.
  • The needleless connector or tubing of the pump is disconnected.
  • A piece of equipment is broken.
  • You are unable to operate the ambulatory infusion pump correctly or to correct problems related to the alarms.
  • The ambulatory infusion pump screen is broken or displayed incorrectly.

Dressing

  • It is damp or soiled with pus or other discharge.
  • It is peeled off, punctured or torn.

Health

Your child:

  • has fever (≥ 38⁰C rectal or ≥ 37.5⁰C buccal or ≥ 37.5⁰C armpit).
  • has a sore ear, throat, neck or shoulder on the side where the central catheter is inserted.
  • smells a particular odor or has a strange taste in the mouth during irrigation of the catheter.
  • hears an unusual sound on the side of the catheter during irrigation.
  • on the side of the catheter, has swelling in the hand, arm, neck or face
  • has pain in the armpit (under the arm) where the catheter is located.
  • appears unwell (eg, pain, irritability, loss of appetite, drowsiness, etc).
  • has a change in baseline health with new symptoms (eg, pain, chills, blood in the stool, vomiting with blood, irritability, agitation, blurred vision, fatigue, weakness, drowsiness, nausea, headache, increased thirst, decreased urination, body swelling, sweating, faster breathing, difficulty breathing, dry skin, dry mouth, etc).
  • has more frequent or larger volume liquid stools (diarrhea) than usual.

Your child’s healthcare team will use your child’s regular appointments to verify the proper functioning of the catheter and parenteral nutrition equipment and will make adjustments to the care as required.

Do not hesitate to contact your healthcare team with any specific questions concerning your child.