Hickman Line Insertion
Introduction
A Hickman line is a tube that is placed into one of your major blood vessels leading to your heart. It is used for giving treatment directly into a vein for a long period of time—such as chemotherapy, antibiotics, food supplements, blood transfusions, or for taking samples of your blood for testing.
Risks and benefits
The benefit of this procedure is that it will save you the discomfort of having needles repeatedly inserted into your veins. It is a very safe and quick procedure. The Hickman line is semi-permanent and should last the course of your treatment.
It is common to get a small bruise around the wound site. Very occasionally the bruise might be large which carries a risk of getting infected and would require treatment with antibiotics.
Very rarely, some damage can be caused to the vein which may need treating by surgery. There is a very small risk of developing breathing problems or bleeding from the procedure.
There is also a risk that the line can become infected. This is reduced by personal hygiene and proper care of your Hickman line.
There is also a small possibility that the line can fall out or that the line will become blocked. If this happens it will need to be replaced. We will discuss all the risks and benefits in detail with you before your procedure.
Day of the procedure
Please do not eat or drink for 6 hours before your procedure. Please take all your medications as usual (except aspirin, warfarin or metformin) and, if you are diabetic, you may take your regular insulin.
Before the procedure
You will be admitted to hospital or already an inpatient. On the ward your nurse will ask you several questions about your health and current medication. Your blood pressure and pulse will also be checked. They will test your blood and ask you to change into a gown. Your nurse will bring you to the X-ray department on your bed.
In the X-ray department you will be seen by a doctor who will discuss the procedure with you before you sign a consent form. Please ask any questions you may have as it is important that you understand what is going to happen.
During the procedure
In the procedure room you will lie on an X-ray bed. Your neck will be cleaned with antiseptic fluid and you will be covered with a sterile drape. The doctor will give you an injection of local anaesthetic to numb the skin in your neck by your collarbone and on your chest. This will cause some stinging initially and then go numb.
The procedure should not cause you any pain. Your pulse and blood pressure will be monitored and you may be given oxygen throughout the procedure. You will also be given some strong pain relief through a cannula in your vein. The Hickman line will be tunnelled under your skin from the chest to the neck. Once it is at your neck it will be placed into a large vein. The doctor will put stitches in your skin to hold the Hickman line in place and a large waterproof dressing will be placed over the line.
The procedure usually takes 30–60 minutes but may take longer.
After the procedure
You will go back to the ward where you will need to rest in bed for 2 hours. Your ward nurse will monitor you. The Hickman line will be ready to use. If you feel unwell or have any discomfort at any time, please tell your nurse.
Going home
If you need treatment for a long period of time, you may be discharged from hospital with your Hickman line still in. You should be able to wear your normal clothes.
You need to keep the dressing clean and dry and not touch the line until your hands have been washed with soap and water. The stitches will need to come out after two weeks.
After you are home
Please contact your ward immediately if you are experiencing any of the following:
- The skin around the line becoming red or inflamed, or if there is any swelling
- Leakage from the site
- Pain at the site
- Fever and chills
- Movement of the line
- Difficulty when flushing the line
Contact information
Chelsea and Westminster Hospital
Interventional Radiology Department
1st Floor, Lift Bank D
T: 020 3315 8570/8582