2012

PAEDIATRIC ONCOLOGY UNIT

PAEDIATRIC DEPARTMENT
HOSPITAL PULAU PINANG

[ GUIDELINE FOR FLUSHING &

DRESSING OF CHEMOPORT &
HICKMAN’S CATHETER]
For Healthcare Staff
2011 Edition
Contents

1. BLOOD TAKING FROM HICKMAN’S CATHETER .................................................................... 3

Introduction: ...................................................................................................................................... 3
Instructions for blood taking ............................................................................................................ 3
Instructions for Connecting to IVD ................................................................................................. 3
2. BLOOD TAKING FROM CHEMOPORT ...................................................................................... 4
Introduction: ...................................................................................................................................... 4
Instructions for blood taking ............................................................................................................ 4
Instructions for Connecting to IVD ................................................................................................. 4

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1. BLOOD TAKING FROM HICKMAN’S CATHETER

Introduction
Hickman’s catheter has 2 limbs.
1 limb is name white lumen and the other limb is named red lumen.
For routine blood investigations, blood can be taken from either one lumen.
As for Blood C&S, bloods need to be taken from both lumen and label accordingly.

Instructions for blood taking

1. The procedure is done under strict aseptic technique with a dressing set, mask
and sterile glove.
2. Proper hand washing is required before starting the procedure.
3. Prepare 7 sterile 10cc syringes for routine blood; 9 sterile 10cc syringes for
Blood C&S into a sterile dressing set.
4. Prepare 2 syringes filled with 10cc Normal Saline each and 2 syringes filled
with 10cc Heparine Saline each, all under aseptic technique.
5. Dilute 0.2cc of pure Heparin with Normal Saline into final volume of 10cc.
(For Heparin block at the end, 5cc into each lumen)
6. Clean the distal end of one lumen at one time with gauze soaked with
povidone followed by alcohol 70% (Spirit).
7. Remove the stopper from the lumen and discard the stopper.
8. Syringe out 3cc of blood and discard.
(The initial 3cc of blood is diluted and not suitable for investigation)
9. Syringe out enough quantity of bloods required for investigations.
10. Flush with 10cc Normal Saline.
(Please use the sterile normal saline in 10cc preparation and keep the empty
bottle after use for exchange)
11. Follow by flushing 10cc Heparin Saline.
(Please use the sterile Heparin saline in 10cc preparation and keep the empty
bottle after use for exchange)
12. Heparin block with 5cc of prepared heparin solution and cap off the lumen.
13. Repeat step 6 – 12 for the other lumen.
Omit step step 8 & 9 if blood C&S is not required – ie flushing only.
14. Apply proper dressing.

Instructions for Connecting to IVD

1. Start the procedure as for blood taking.
Follow step 1 – 11
(Step 8&9 can be omitted if blood investigations not required)
2. Start infusing IV drip or medications as per order.
(All flushed CVL required at least 10cc/hour through the CVL to maintain the
patency of the CVL).
3. Apply proper dressing

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2. BLOOD TAKING FROM CHEMOPORT

Introduction
Chemoport needle needs to be inserted before flushing or blood taking can be done.
All patients should received EMLA cream (Analgesia) on the chemoport site at least
15 minutes before the needle is inserted.

Instructions for blood taking

1. The procedure is done under strict aseptic technique with a dressing set, mask
and sterile glove.
2. Proper hand washing is required before starting the procedure.
3. Prepare 5 sterile 10cc syringes for routine blood and chemoport needle.
4. Prepare 1 syringes filled with 10cc Normal Saline each and 1 syringes filled
with 10cc Heparine Saline each, all under aseptic technique.
5. Dilute 0.6cc of pure Heparin with Normal Saline into final volume of 3cc.
(For Heparin block at the end)
6. Clean the chest wall with gauze soaked with povidone followed by alcohol 70%
(Spirit).
7. Palpate for the chemoport.
Chemoport - It feels like 20 cents coin under the skin.
Babyport – It feels like 10 cents coin under the skin.
8. Puncture the skin with the chemoport needle right into the centre of the ‘coin’
until you feel a resistant like hitting a metal.
9. Syringe out 3cc of blood and discard.
(The initial 3cc of blood is diluted and not suitable for investigation)
10. Syringe out enough quantity of bloods required for investigations.
11. Flush with 10cc Normal Saline.
(Please use the sterile normal saline in 10cc preparation and keep the empty
bottle after use for exchange)
12. Follow by flushing 10cc Heparin Saline.
(Please use the sterile Heparin saline in 10cc preparation and keep the empty
bottle after use for exchange)
13. Heparin block with 3cc of prepared heparin solution and remove needle.
14. Apply proper dressing.

Instructions for Connecting to IVD

1. Start the procedure as for blood taking.
Follow step 1 – 11
(Step 8&9 can be omitted if blood investigations not required)
2. Start infusing IV drip or medications as per order.
(All flushed CVL required at least 10cc/hour through the CVL to maintain the
patency of the CVL).
3. Apply proper dressing.

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