Which method of drug administration does the nurse State is commonly used in toddlers when the child has poor intravenous IV access?

A central line (or central venous catheter) is like an intravenous (IV) line. But it is much longer than a regular IV and goes all the way up to a vein near the heart or just inside the heart.

Table of Contents Show

What Are the Types of Central Lines?
When Are Central Lines Used Instead of Regular IV Lines?
How Can Parents Help?

A patient can get medicine, fluids, blood, or nutrition through a central line. It also can be used to draw blood.

What Are the Types of Central Lines?

Commonly used central lines include:

When Are Central Lines Used Instead of Regular IV Lines?

Doctors might use a central line instead of a regular IV line because:

It can stay in place longer (up to a year or even more).
It makes it easier to draw blood.
Patients can get large amounts of fluids or medicines (like chemotherapy) that might not go through regular IVs.

Doctors may place a central line for someone who:

has a serious infection so they can get IV for a few weeks
has cancer so they can get chemotherapy and blood tests through the line
needs IV nutrition
will need many blood transfusions

Most of the time, central lines do not cause any problems. If problems do happen, it is usually because the line gets infected or stops working. Very rarely, a central line can cause a blood clot. Doctors review the risks with families before placing the central line.

How Can Parents Help?

If your child has a central line, you can help care for it to prevent infection and keep it working well. It's normal to feel a little bit nervous caring for the central line at first, but soon you'll feel more comfortable. You'll get supplies to use at home, and a visiting nurse may come to help you when you first get home.

Before your child goes home from having the central line placed, ask your health care team:

how often to change the dressing
when and how to flush the line
what to do if the line gets blocked or comes out
how to give medicines through the central line (if you will be giving medicines at home)
if the line has caps, how often to change them
which physical activities are OK for your child (most kids need to avoid rough play and contact sports)
if any special care is needed to protect the central line while your child bathes
what signs of infection to watch for

Tell your child's teachers, school nurse, counselor, and physical education teacher about the central line. They can make sure your child avoids any activities that may damage the line, and help support your child during treatment.

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Page 2

From: Challenges Associated with Route of Administration in Neonatal Drug Delivery

Route of administration	Physiologic factor	Function in neonates compared with adults	Effect on bioavailability/deliverability of drug from selected dosage form	References
Oral	Stomach pH	At birth: more basic within 24 h Postnatal: approximately adult levels (1–3) 1 week postnatal: more basic	Weakly basic drugs will have increased bioavailability in basic stomach environment, while weakly acidic drugs will have decreased bioavailability	[8–11, 13, 14, 143]
Gastric emptying	Reduced	Decreased absorption rate	[9, 15, 16]
Intestinal surface area	Reduced	Decreased absorption	[9]
Intestinal motility and peristalsis	Reduced	Increased absorption	[15, 26]
Intestinal P-gp expression	Reduced	Increased absorption	[29]
Intestinal CYP metabolism	Varied depending on CYP, but decreased in most cases	Depends on CYP, but often increased bioavailability due to decreased metabolism	[30–33, 35]
Intravenous	Blood volume	Reduced	Limitation to carrier flow rate for IV fluids	[15, 52, 54]
Intramuscular	Muscle mass	Reduced	Restricts options for IM delivery	[15, 69, 70]
Muscle vascularization	Variable	Can result in reductions or fluctuations of IM drug reaching systemic circulation	[69]
Subcutaneous	Subcutaneous fat	Reduced	Can result in drug leaking from depot	[15, 80]
Topical and transdermal	Stratum corneum thickness	<35 weeks’ gestation: reduced ≥35 weeks’ gestation: approximately adult thickness	Increased systemic bioavailability for neonates <35 weeks’ gestational age	[81]
Stratum corneum hydration	Increased	Increased bioavailability for most hydrophilic drugs	[12, 82]
Surface area to bodyweight ratio	Increased	Increased bioavailability	[12, 82]
Intrapulmonary	Lung branching and development	Immature	Unclear, potentially decreased lower lung deposition/bioavailability	[86, 87]
Inspiratory flow and volume	Decreased	Reduced likelihood of upper airway impaction, potential for increased bioavailability	[87]
Rectal	Size of rectum	Reduced	Potential for reduced bioavailability due to inability to avoid portal absorption	[123]