This script is in the process of conversion from a pdf file to a wiki file.
In the meantime you can still use the pdf version below.
REMOVAL OF HICKMAN LINE
A PANTOGEN OPERATION SCRIPT
MICHAEL EDWARDS
NO INFORMATION IN THIS SCRIPT SHOULD BE USED WITHOUT THE APPROVAL OF A FULLY TRAINED PRACTISING SURGEON
THIS SCRIPT COVERS: =
LAY OUT OF OPERATION SECTIONS AND STEPS
The operation is divided into SECTIONS.
The SECTIONS are displayed in sequence in the following paragraphs.
Each SECTION is divided into an unlimited number of very small STEPS.
Each STEP contains an unlimited amount of supporting information (PANTINOS)
SECTION 1.00 PRELIMINARIES
STEP 1.01 CHECK YOU HAVE THE CORRECT PATIENT
STEP 1.02 CHECK YOU HAVE THE CORRECT SIDE.
Standard cleaning up and towelling up.
Expose the patient from above the clavicle, the mid line 10cm below the exit of the Hickman line and the anterior axillary fold.
Pull on the line to test where there is tethering.
Usually the Teflon cuff will be just under the exit opening.
Infiltrate the wound. Dissect out the line until you meet the Teflon cuff.
The Teflon cuff is 1cm long. It may be very adherent to the surrounding tissues.
Free off the cuff along its length and identify the rest of the line beyond the cuff towards the vein.
Apply pressure to the subclavian vein and pull out the Hickman line.
Check that it has all come out.
Have a swab taken from the tip.
Close the wound with subcuticular vicryl.
(You will need Abobe Acrobat Reader which can be downloaded from here)
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Michael Edwards
Email michaeledwardsOK@aol.com
