There are several methods of delivering chemotherapy in use at CCL, one of which is the Hickman Line. This is a soft plastic tube, or catheter, that is tunnelled beneath the skin and placed in a large vein, and can be used to place fluids and drugs straight into the bloodstream. It can also be used to take blood samples, and both of these functions save the patient from repeated injections and needle pricks during treatment. The catheter can have either double or triple channels and each has a clamp in place which is used to close the line when it is not in use.
A Hickman Line is inserted using a local or general anaesthetic. A suitable vein is located using an ultrasound of the neck, and then a small incision is made near the collarbone. The small silicone tube is then gently threaded into the vein, until it reaches the chest. Here a second incision is made and the end of the tubing is pulled through the skin. The line is held in place at either end by a small stitch.
Once the Hickman Line has been inserted, it is important that it stays clean, dry and in place. For the first week or so the line must be covered by a waterproof dressing, until the incision has healed. Patients with a Hickman Line must not go swimming, and should avoid any vigorous upper body activity. When showering, the line must be covered by a waterproof dressing, and when bathing the line must remain above the water at all times.
In order to keep the line clean, it must be flushed once a week. This can be done by a nurse or doctor at CCL, and a nurse can teach the patient or a family member how to flush the line themselves, if necessary.
If you experience a cold and shivery attack during or after flushing your line, contact the doctor or nurse caring for you immediately, as this could be due to an infection in the line, which will require immediate treatment.
You should also contact the hospital straight away if:
- you experience pain, redness or swelling in your arm or neck on the same side of the body as your line
- the cuff or line has moved
- you feel breathless
- your line becomes damaged or develops a leak.