What precautions should be taken with a tunneled catheter?

September 26, 2025 •

4 min read

According to studies, catheter-related bloodstream infections are a significant concern, emphasizing the need for meticulous care to prevent complications. This guide outlines the essential precautions you should take with a tunneled catheter to ensure your safety and well-being, from daily maintenance to identifying potential issues.

Quick Summary

Taking care of a tunneled catheter involves vigilant infection prevention, including proper site and dressing care, securement to prevent displacement, and avoiding water immersion. It is crucial to monitor for signs of infection and understand when to seek immediate medical attention. Adherence to professional guidance for flushing and activity limitations ensures long-term safety and functionality.

Key Points

Infection Prevention: Rigorous hand hygiene and proper sterile dressing changes are the most critical precautions to prevent infection at the exit site.
Catheter Securing: Secure the catheter to your body with tape to prevent accidental pulling or damage, and avoid wearing snag-prone jewelry or clothing.
No Water Immersion: Never submerge the catheter in water; use waterproof covers for showering and avoid baths or swimming.
Monitor for Complications: Check the exit site daily for redness, swelling, or drainage, and contact your doctor immediately if you notice signs of infection.
Activity Restrictions: Avoid strenuous activities, contact sports, and heavy lifting that could damage or dislodge the catheter.
Professional Care: Flushing the line and performing complex maintenance should only be done by a trained professional or caregiver.
Recognize Red Flags: Know when to seek immediate medical attention, especially for fever, chills, catheter damage, or breathing problems.

Understanding Your Tunneled Catheter

A tunneled catheter is a type of central venous catheter that is inserted into a large vein, usually in the neck or chest. It is then tunneled under the skin before exiting at a separate site on the chest. This design, which includes a cuff for tissue ingrowth, provides long-term venous access for weeks, months, or even years. These catheters are used to administer medications like chemotherapy, provide nutritional support (parenteral nutrition), or facilitate hemodialysis. The long-term nature of these devices means that consistent and careful maintenance is essential to prevent serious complications, most notably infection.

Essential Daily and Weekly Care

Infection prevention is the single most important aspect of tunneled catheter care. The steps below are critical for minimizing risk:

Hand Hygiene

Always wash your hands thoroughly with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer before touching the catheter or its dressing. This is the first line of defense against introducing germs.

Dressing Changes

Follow your healthcare provider's specific instructions for dressing changes. The dressing over the exit site is a sterile barrier against infection.
Change the dressing immediately if it becomes wet, dirty, or loose.
When changing the dressing, wear sterile gloves and use the supplies provided in your discharge kit.
Follow a strict sterile technique: clean the site with the antiseptic solution provided (e.g., chlorhexidine gluconate) and allow it to dry completely before applying the new sterile dressing.

Site Inspection

Check the catheter exit site daily for any signs of infection. Look for redness, swelling, warmth, tenderness, pain, or any drainage (pus or blood).
Inspect the catheter tubing itself for any cracks, leaks, or damage.
If you notice any of these signs, contact your healthcare provider immediately.

Protecting Your Catheter from Damage and Dislodgement

Securing the Catheter

Secure the external portion of the catheter to your chest using tape to prevent it from dangling or being pulled. Tugging on the line can cause pain, dislodgement, or damage.
Avoid using sharp objects like pins or scissors near the catheter tubing.
Wear loose-fitting clothing that won't snag or pull on the line.

Clamps and Connectors

Ensure all clamps on the lumens are closed when not in use.
Always keep an extra emergency clamp with you in case of a catheter break or leak.
Follow proper protocols for changing needleless connectors and disinfection caps, as instructed by your nurse, to maintain sterility.

Water Immersion and Activity Restrictions

Bathing and Showering

Never submerge the catheter in water. This means no swimming in pools, oceans, or taking baths.
To shower, use a waterproof cover, such as an Aquaguard®, to completely protect the dressing and catheter site from getting wet.

Physical Activity

Discuss any new or strenuous physical activity with your doctor.
Avoid contact sports, heavy lifting, and any vigorous upper body movements that could pull on the catheter.
Take care with seat belts to ensure they don't rub or put pressure on the catheter site.

Managing Common Issues and When to Call for Help

Troubleshooting Minor Problems

If the dressing becomes loose or dirty, call your doctor's office for guidance. You may need to apply a new dressing over the old one until you can have it properly changed.
For a leaking catheter, clamp the line above the leak and contact your healthcare provider immediately.

When to Seek Medical Attention Immediately

A fever of 100.4°F (38°C) or higher, or chills.
Signs of infection at the exit site, such as increasing redness, swelling, warmth, or drainage.
The catheter is leaking, cracked, or completely comes out.
Resistance when flushing the line.
Swelling in your face, neck, arm, or chest on the same side as the catheter.
Chest pain or shortness of breath.

Tunneled Catheter vs. Implantable Port


Feature	Tunneled Catheter	Implantable Port
Access Method	A tube exits the skin, providing external access to the vein.	A catheter with an attached reservoir is entirely beneath the skin; a needle is inserted through the skin to access the port.
Longevity	Can be used for weeks to months, or longer, depending on the need.	Provides permanent access, often lasting years.
Visibility	External tubing and dressing are visible on the chest.	A small bump is visible where the reservoir is located, with no external components when not in use.
Infection Risk	Higher risk of infection due to the external exit site.	Lower risk of infection due to being fully implanted beneath the skin.
Activity	Activities like swimming and contact sports are often restricted.	Fewer activity restrictions once the site is healed.

The Importance of Professional Guidance

Home care for a tunneled catheter, including flushing and changing end caps, should only be done after being properly trained by a healthcare professional. Regular appointments are necessary to maintain the line and check for complications. Your healthcare team is your most important resource for ensuring safe and effective catheter management.

Following these guidelines will help ensure the longevity and safety of your tunneled catheter. Being proactive and vigilant in your care, and knowing when to contact your healthcare team, is the best way to prevent complications and maintain your health.

For more information on venous access devices and patient safety, you can consult reputable medical resources, such as the Memorial Sloan Kettering Cancer Center website.

Frequently Asked Questions

The frequency of dressing changes for a tunneled catheter depends on the type of dressing used and your doctor's instructions. A clear, transparent dressing is typically changed once a week, while a gauze dressing may need to be changed more frequently. Always change the dressing immediately if it becomes wet, loose, or dirty.

Signs of a catheter infection include increased pain, swelling, warmth, or redness at the exit site. You might also notice pus or bloody drainage, experience fever or chills, or see red streaks extending from the site. Any of these symptoms warrant immediate contact with your healthcare provider.

Yes, you can shower with a tunneled catheter, but you must protect the site from water. Use a waterproof cover specifically designed for this purpose, like an Aquaguard®, to completely seal the dressing. Avoid baths and swimming, as you should never submerge the catheter in water.

Mild exercise may be permitted, but you should avoid strenuous activities, heavy lifting, and contact sports. These activities can put stress on the catheter and increase the risk of dislodgement or damage. Always consult your doctor or nurse before starting any new exercise routine.

If your catheter breaks or leaks, remain calm and immediately clamp the catheter between the leak and where it exits your skin. Then, contact your healthcare provider or clinic right away for further instructions. Never attempt to repair the line yourself.

You can secure the catheter by taping the lumens to your skin or clothing to prevent accidental pulling. Avoid taping over the connector site. Using a medical tape and pinning it to your clothing is an effective method, but remember to unpin it before changing clothes.

A tunneled catheter is placed partially under the skin and is designed for long-term use, weeks to months. In contrast, a non-tunneled catheter is inserted directly into a vein and is typically used for short-term access, a few days to a week. The tunneled design helps reduce the risk of infection for long-term therapy.