Confusion over Hickman Line maintenence

Everywhere I look I get conflicting information on how to carefor Sally's Hickman Line. Some trusts say flush twice a week, some once. Some trusts say use a Heparin lock, some don't. Some trusts say aspirate before flushing, some don't. Some trusts use a bionectar, some don't. In fact, there is even confusion within my local trust because on the Oncology ward they flush once a week and don't use bionectars whereas at the Oncology Outpatient Treatment Centre they flush twice a week and use bionectars!
It seems we are going to have to make up our own minds on how often to flush and how to do it and so I have read all the material I can find on the web (of which there is loads as many trusts publish their line maintenence guidelines), I have listened to the specialist nurses at the hospital and I have spoken to a specialist cancer nurse at MacMillan Cancer Support and these are my conclusions:

  • always use an aseptic procedure… obviously that doesn't vary much between trusts
  • many trusts don't aspirate blood beforehand and as I haven't been shown the correct procedure to do it then I won't aspirate
  • use a bionectar and change it weekly
  • change dressing when required or weekly
  • I am not given Heparin so I won't be using a Heparinised saline lock
  • I will flush every 4 days. This is a compromise between the weekly and twice a week (both of which seems acceptable) but one that fits nicely with the chemo treatment intervals. So I will be flushing 4 times between chemo sessions

So that is our conclusions. It isn't cast in stone and if we change things again I will repost but for now that is how we are looking after the line.


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