Download Hickman Line Insertion

Hickman Line Insertion – Patient information
What is a Hickman line and why is it used?
A Hickman line is a type of central venous device. It is inserted into a vein in
your neck and the tip lies in a large vein just above your heart and the other
end passes under the skin and emerges on your upper chest.
The Hickman line is made of a thin, soft non-irritant, latex-free material
silicone, which you cannot feel inside you. The line will not show under a shirt
or blouse.
The Hickman line is a comfortable and safe means of giving chemotherapy or
other intravenous treatments. There are many different types of
chemotherapies; some of these cannot be given by peripheral cannula or
PICC line and can only be given through a Hickman line. Sometimes your arm
veins may not allow placement of a peripheral cannula or PICC line.
It is possible to withdraw blood samples from the Hickman line.
Preparation for your procedure?
You will be given a date and time for your Hickman line to be inserted by the
Oncology unit. You should not eat or drink for 4 hours before the procedure.
You can take your regular medications with a small amount of water.
You cannot drive for 24 hours after you have had your line put in. Someone
will need to drive you home afterwards. This is because you may be sedated
during the procedure.
How is the Hickman line put in?
The line will be inserted in the x-ray department by a Consultant Radiologist.
The procedure will be explained to you and you will be given the opportunity
to ask questions. If you are happy to proceed, you will be asked to sign a
consent form.
The procedure is performed under sterile conditions to avoid the risk of
infection. You will be asked to put on a hospital gown and lie flat on the x-ray
couch. A small drip will be put into your arm if you chose to have sedation to
relax you. If you chose sedation we give you oxygen via a tube in your nose
(because you do not breath quite as deeply under sedation). Your blood
pressure and oxygen level will be monitored.
Local anaesthetic is injected into the skin of the neck and chest to “numb” the
area. The Hickman line is inserted into a large vein in the lower part of the
neck or upper chest using ultrasound guidance and is guided into position
using x-rays. The other end of the line is tunnelled under the skin to the chest
wall just below your collarbone. It is only at this point your line becomes
visible.
There is a cuff, which feels like a small lump under your skin in the ‘tunnel’,
which holds the line in place. Two stitches will be placed to hold the line in
position until the cuff heals in place to fix the line. The stitches will be removed
by one of the oncology nurses after approximately 21days.
Where the line comes out onto your chest it will be covered with a seethrough, waterproof dressing.
After your Hickman catheter is placed?
Once you have had your line placed, you will be able to sit up and have
something to eat and drink. Your neck and chest may feel tender but for no
longer than 48 hours.
Risks and complications?
As with every procedure there are some complications and risks.
The main risk with Hickman lines is infection, especially as immunity is often
reduced by chemotherapy. To reduce the risk staff caring for or using your
Hickman line will wash their hands and wear gloves before touching your line.
The end of the line will always be cleaned thoroughly before use.
There is a small risk that thrombosis or “clot” can occur in the vein around the
Hickman line. This can cause shoulder/neck pain or a swollen head, face or
arm.
Who will look after the catheter?
The oncology unit staff will look after your Hickman line. The nurse will
change the dressing and clean the area where the catheter goes into your
skin. The nurse will also flush the line and take blood samples as necessary.
Sometimes the district nurse will also be involved in the care of your Hickman
line.
Bathing and showering?
You may do both. However, if you have a shower, stand in the shower with
your back to the water. When you have a bath, never immerse your line under
the water. Getting it wet may increase the risk of infection. You will not be able
to swim with a Hickman line in place. Please do not allow anything to pull or
drag on the catheter.
What to look out for?
If the skin around your PICC becomes red, painful or if you feel “shivery” or
cold after your line has been flushed, it may mean you have an infection. If
your arm, shoulder or neck becomes painful, or swollen this may indicate a
clot in the vein. In these circumstances please contact the Oncology Unit.
Further Information
Please contact Berkshire Imaging.