Hickman catheters are a type of central venous catheter, a thin, flexible tube inserted into a large vein in the chest. This device provides long-term access to the bloodstream, often for months or years, allowing consistent venous access without repeated needle sticks.
Medical Uses
Hickman catheters offer direct access to the bloodstream, which is beneficial for various medical treatments. They are commonly used for administering chemotherapy, a cancer treatment that requires regular infusions of medication. The catheter also facilitates long-term intravenous (IV) antibiotic therapy, which is often necessary for persistent infections.
Patients who cannot absorb nutrients through their digestive system may receive total parenteral nutrition (TPN) via a Hickman catheter, providing essential liquid food directly into the bloodstream. The catheter also allows for frequent blood draws for lab tests, reducing the need for multiple venipunctures. Using a central line for these purposes helps prevent irritation that can occur when certain medicines are given through smaller veins in the arm or hand.
Placement Procedure
The insertion of a Hickman catheter is a minor surgical procedure, typically performed by an interventional radiologist or surgeon. The process usually involves two small incisions: one near the neck or collarbone where the catheter enters the vein, and another on the chest wall where the catheter exits the body. The catheter is then “tunneled” under the skin between these two incisions, with a cuff attached to help secure it and act as an infection barrier.
During the procedure, ultrasound imaging guides the needle into the vein. X-rays are used to confirm the catheter’s position, ensuring the tip rests in a large vein just above the heart. The procedure is typically done under local anesthesia with sedation, allowing the patient to remain comfortable while awake.
Daily Life with a Hickman Catheter
Living with a Hickman catheter involves routine care to ensure its proper function and to minimize complications. Regular dressing changes are necessary, with frequency depending on the type of dressing used; transparent dressings may be changed weekly, while gauze dressings might require more frequent changes. The insertion site should be inspected daily for any signs of redness, swelling, heat, pain, or unusual discharge.
Maintaining cleanliness is important; patients are advised to cover the catheter with a waterproof dressing when showering to keep the exit site dry. General activities like cooking or sweeping are permissible, but strenuous activities such as swimming or contact sports are discouraged to prevent dislodgement or damage. Each lumen of the catheter needs regular flushing, often daily or weekly with saline, and sometimes with heparin, to prevent blockages. Healthcare providers will provide specific instructions on daily care.
Recognizing Potential Complications
Despite careful management, individuals with a Hickman catheter should be aware of potential complications. Infection is a concern, which can occur at the insertion site or enter the bloodstream. Signs of infection include fever (100.4° F or 38° C or higher), redness, swelling, warmth, pain, or drainage from the catheter site.
Blood clots can also form in the catheter or the vein, potentially leading to swelling, pain, or redness in the neck, shoulder, arm, or chest. Catheter damage or dislodgement, which might be indicated by the external portion of the tube appearing longer than usual or difficulty flushing, also warrants immediate attention. Should any of these symptoms arise, it is important to contact a healthcare provider promptly for evaluation and guidance.