THE CENTRAL VENOUS CATHETER FOR YOUNG-PATIENTS - AN UMBILICAL-CORD FANTASY

Central Venous Catheter (CVC) allows the administration of drugs, pare nteral nutrition and blood sample taking for laboratory tests, avoidin g continuous damage to the peripheral veins. Most of the psychological traumas caused by crude treatments also decrease and therefore CVC ma y initially be experienced as the end of continuous physical injuries. Nevertheless, it often happens that other sorts of psychological trau ma, due to fantasies and fears elicited by the CVC, arise in children and their families. The CVC is often felt as a dangerous and invasive ''foreign body''. Moreover after it has been used for a long time it m ay create a psychological state of dependency and it frequently become s the only means of salvation. This makes removal particularly difficu lt and it is felt as a ''cutting'' of the CVC at the end of the therap y. Young patients elaborate complex fantasies about the starting point , the route and the end point of the catheter. Their parents are often unknowing accomplices of these fears, partially because they project their own experience and also because they are conditioned by the way they have elaborated the information provided by the assistance staff. Since the handling of CVC is under the parent's responsibility when t he child is not in Hospital, we should be able to help the patients an d their families to cope with this experience in the most suitable way . This makes it possible to avoid both excessive worries and the tende ncy to underestimate the risk of infection. This is why we consider th at submitting children and their family members to interviews, surveys and spontaneous drawing is wise in order to evaluate the existence, n ature and extent of the fantasies. This helps to modify possible disto rtions both of perception and behavior.