Doctors should be vigilant when they decide to send home some pediatric cancer patients who still need to use a central venous catheter for their treatment. Because the central line is a tube that is placed directly into a major blood vessel, it can easily become a gateway for bacteria in the blood stream if it is not handled properly. Central line-associated bloodstream infections (CLABSIs) can lead to serious personal injury such as organ damage and sometimes death.
A recent study from Johns Hopkins Children’s Center published yesterday in the journal Pediatric Blood & Cancer followed 319 children with cancer between 2009 and 2010. Most children were first treated in the hospital and then sent home to continue their treatment. 19 children developed a central line-associated bloodstream infection (CLABSI) while hospitalized and 55 while at home.
Hospitals have been fighting for a long time against bloodstream infections and they have made serious progress in reducing them. They have experienced clinicians following precise protocols.Things are different when children are treated at home by family members. More should be done in preventing development of CLABSIs at home.For example teaching family members how to handle and clean central lines should be part of the formal discharge protocol. It is not the case yet.