A Hickman line is a long, soft tube that is put in under a local or general anaesthetic. It runs under the skin of the chest and into a large vein, with its tip close to the heart. The other end comes out through the skin and is closed with a cap when it is not in use.
Under the skin there is a small cuff that the body grows around. That holds the line in place and helps keep germs from tracking along it. Lines like this can stay in for months or years if they are looked after well.
Why it matters so much
Your line is your lifeline. Because it goes straight into the blood near the heart, an infection in the line can become serious very quickly. That is why the clean routine you are taught for every connection and disconnection is so important.
Everyday care
- Wash and dry your hands well before you touch your line, and follow your clean technique every time.
- Keep the dressing clean, dry and in place, and change it as you have been shown.
- Keep the line clamped and capped when it is not in use, and secure it so it cannot be pulled.
- Do not use scissors or anything sharp near the line.
- Keep the line out of water. Showers are usually fine with the line covered, but baths that cover it and swimming are usually not allowed. Ask your team what is safe for you.
Warning signs: contact your nutrition team straight away
- A temperature, shivering or feeling suddenly unwell, especially soon after connecting a feed.
- Redness, swelling, pain, heat or discharge where the line comes out of the skin.
- Swelling of the arm, neck or face on the side of the line.
- The line will not flush, leaks, cracks or looks damaged. If it is damaged, clamp it above the damage as you were taught.
If you feel very unwell, are confused, or are struggling to breathe, call 999 and tell them you have a central line for parenteral nutrition.
Remember: keep the phone number of your nutrition team, and the out of hours number, somewhere you can always find it.