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Warning-sign checks

Percutaneously inserted central catheter - infants: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services if your infant has severe breathing difficulty, becomes unresponsive, or develops sudden blue or grey colouring.

    These are emergency symptoms rather than routine line-care concerns.

    And for anyone, someone who:

    • is bleeding heavily and it will not stop with firm pressure
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    While your infant is in hospital, tell a nurse promptly about any concern involving the line or nearby limb.

    After discharge, contact the PICC or neonatal team urgently for:

    • Fever, unusual temperature changes, marked sleepiness, or poor feeding
    • Redness, warmth, swelling, pain, or drainage near the insertion site
    • Swelling, coolness, paleness, or bluish colour in the affected limb
    • Fluid leaking from the line or under the dressing
    • A wet, loose, dirty, or lifting dressing
    • A visible change in the catheter’s external length
    • Resistance, repeated pump alarms, or treatment that will not run
    • A cracked, disconnected, or accidentally pulled catheter

    And for anyone, someone who:

    • has a wound that is hot, spreading red, or leaking pus

The article also says

Clamp the catheter if you were trained to do so and it breaks or disconnects.

Do not push an exposed section back under the skin.

Every sign above is quoted from the sofidex article on Percutaneously inserted central catheter - infants. If you are not sure, err upward — it is always reasonable to be checked.