What is a Hickman Line?
A Hickman line is a central venous catheter; a long hollow tube, with one, two or three lumens, this allows for different treatments to be given at the same time.
A Hickman line is most often used for the administration of chemotherapy or other medications, as well as for the withdrawal of blood for analysis.
How is a Hickman Line inserted?
A Hickman line is inserted under local anesthetic into a vein in the neck, it usually takes around half an hour.
You will be asked to lie on a table, where the radiologist will inject some local anesthetic into your chest and neck to numb the area. This may sting a little as it goes in and then go numb. You should only feel pressure not pain.
Your neck will be checked for a suitable vein using a small ultrasound machine. The area where the line is to be inserted is cleaned with an antiseptic fluid and you will be covered with a sterile drape.
A small cut is made in the skin near your collarbone and the tip of the tube is threaded into a large vein. This is known as the insertion site. The tube is then pushed under the skin from the neck to the chest to reach the exit site where a second small incision is made. The exit site is the place where the tube comes out of your body.
After the line has been put in you will have a chest x-ray to make sure that it is in the correct place and a waterproof dressing will be placed over the line.
There is a small ‘cuff’ around the Hickman Line which can be felt under the skin just above the exit site that prevents it from falling out. The tissue under the skin grows around this cuff over a period of about three weeks and holds the line safely in place. Until this has happened you will have a stitch holding the line in place.
If you are going home on the same day it is advisable to have someone with you to help you home, it is not recommended to use public transport.
How do I care for my Hickman Line?
Hickman lines can get infected very easily, if infected it may result in the removal of the line.
Flushing your line regularly will help to prevent it becoming blocked. It is recommended that your line is flushed once a week. The stops at the end of your line should be changed at the same time. This will be done in the ward or day unit where you get your treatment. The day unit or ward nurses can teach you how to flush your line at home if required. Alternatively a district nurse can be asked to see you at home to change the dressing and flush the line.
If your line is not being used, the plastic clamp must stay closed
Showering with a Hickman Line
Use a waterproof dressing over the tubing as this will help keep it dry during a shower. The hospital will normally provide some dressings and advice on how to use them after you leave hospital.
You will generally need a dressing for the first two weeks after the insertion, until the exit sites have healed and stitches have been removed.
Afterwards, you can use our showerproof holder, specially designed for showering with a Hickman line.
Adam ready for a shower wearing his Central Line Holders’ showerproof cover.
Having a Bath
Bathwater is not as clean as shower water so if you have a bath ensure that you keep the Hickman Line out of the water at all times, keeping the water shallow will help.
Sports with a Hickman Line
Sports like tennis, golf or strenuous gym exercises should be avoided. There is a risk your Hickman line could become dislodged due to a lot of upper body movement. Your doctor/nurse can advise you about other sports which are acceptable. You must not swim with a Hickman Line
What are the benefits of a Hickman Line?
A Hickman Line enables nurses and doctors to give you intravenous medicines (medicines that need to go directly into a vein), nutrients or to take blood samples. It means you can avoid needle puncture every time you have treatment, which can be uncomfortable and stressful.
Some medications need to be given into a large vein rather then small vein in the hand/arm. Doctors recommend the use of a Hickman line for patients who regularly have chemotherapy, long-term antibiotics and infusions.
How is a Hickman Line removed?
When you no longer need the Hickman line it will be taken out. A doctor or nurse specialist delivering your treatment will do this for you.
It is usually a very quick procedure. You will be asked to lie on a bed. The area around the cuff is cleaned with antiseptic fluid and numbed with local anesthetic. A small cut is made to gently release the cuff and the line is then removed slowly. No stitches are required. This can feel uncomfortable, but it should not be painful. Patients don’t usually need sedation.
A dressing will be put over the exit site and you will be asked to remain lying down (for about 10 minutes) until it is certain that there is no bleeding. When you feel ready you will be asked to sit up and get dressed. You will be returned to your ward if you are an inpatient or you will be able go home if you came in as an outpatient.