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Treatment and the treatment process

Access for long-term treatment

When treatment lasts for months, venous access becomes part of daily life. This topic explains how to live safely with long-term access (a PICC, a tunnelled line or a port) for months, how it is cared for and which problems can occur.

Last updated: ~3 min read
A coiled thin PICC line, a protective sleeve and a clear dressing on a clean tray.
Figure 1.A PICC and its protective supplies.

01Short answer

Long treatments (such as lengthy ALL programmes, consolidation or transplant) use three main types of access: a PICC, a tunnelled line and a port. They can stay for months but need regular care: a PICC and a tunnelled line are usually flushed and redressed weekly, while an unused port is flushed less often. The main complications are infection, clots (inside the line or in the vein), blockage and the line moving. Knowing the early signs and calling promptly keeps most of these problems simple to sort out. Showering, sleep, work and light activity are usually possible; swimming is not allowed with a PICC or tunnelled line.

02Simple explanation

Care schedule. Flushing and dressing changes are usually weekly, done by a nurse in hospital, a clinic or at home.

Water. Protect the line with a waterproof cover in the shower. No pools, sea or baths with an external line; with a port, swimming is fine once healed.

Movement. Avoid lifting heavy things or repeated strong movements with the PICC arm. Walks and light exercise are helpful.

Signals. Fever, chills, redness, discharge, swelling and resistance when flushing are reasons to call your team.

03Scientific explanation

Infection: according to the CDC, most line-related bloodstream infections start with germs on the skin or at connectors. Hand hygiene, chlorhexidine skin cleaning and a closed system reduce the risk.

Clots: according to CRUK and MedlinePlus, PICCs and central lines raise the risk of a clot in the vein (thrombosis); signs are swelling and pain in the arm, shoulder or neck. This is usually checked by ultrasound and treated.

Blockage: if a clot or deposit forms inside the line, flushing becomes difficult. A healthcare worker may unblock it with a special medicine; it must never be forced at home.

04What happens in the body?

Daily rules at home

Wash your hands before touching the line. Keep the dressing dry and covered; report it if the edges lift. Know the external length of the line (the nurse records it for a PICC) and say if it changes. Keep sharp objects away from the line.

At home, a calendar, a box of sterile supplies, a thermometer and a notebook in warm evening light.
Figure 2.Care schedule and supplies in one place.

What to watch for

Fever and chills, especially during flushing; redness, pain or discharge at the site; swelling of the arm, shoulder or neck; resistance or leaking when flushing; a crack in the line.

A translucent vein on a dark navy background with a soft red glow at one point.
Figure 3.Watch for signs of a clot or infection.

Quality of life

Many people with lines work, go for walks and spend time with their children. Loose sleeves, a protective sleeve or a small pouch add comfort. If you plan to travel, agree in advance with your team where your line care will be done.

05The weekly care cycle

To keep a line working for a long time.

Flush — Usually weekly.1FlushUsually weekly.
Dressing — Clean, dry, covered.2DressingClean, dry, covered.
Shower — With a waterproof cover.3ShowerWith a waterproof cover.
Call — Straight away with a warning sign.4CallStraight away with a warning sign.
InfectionFever, chills.
ClotSwelling, pain.
BlockageHard to flush.

06Caring for long-term access

AccessFlushingDressingSwimming
PICCUsually weeklyUsually weeklyNo
Tunnelled lineUsually weeklyOften until healed, then regularlyNo
Port (unused)Usually every 4–12 weeksNot neededAllowed once healed

* Your team sets the exact schedule.

07Key terms

PICC
A central line inserted through the arm.
Thrombosis
A clot forming in a vein.
Blockage
The inside of the line becoming closed.
Closed system
Needle-free caps that reduce germ entry.
Dressing
A sterile cover over the line site.

08Key points

  • Long-term access can stay for months.
  • Regular flushing and dressing changes matter.
  • Infection is the main danger.
  • Swelling can be a sign of a clot.
  • Do not flush the line yourself.
  • Call straight away with a warning sign.

09Frequently asked questions

Can I exercise with a PICC?

Walks and light exercise are fine; heavy lifting, swimming and contact sports are not.

My line has been fine for months. Does it still need checks?

Yes, regular care prevents problems.

I had chills during flushing. What should I do?

This can be a sign of line infection; tell your team straight away.

When will the line come out?

When treatment is over, or if a complication occurs.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Can I exercise with a PICC?

  2. My line has been fine for months. Does it still need checks?

  3. I had chills during flushing. What should I do?

  4. When will the line come out?

My questions

12Sources

  1. MedlinePlus. Peripherally inserted central catheter - flushing
  2. MedlinePlus. Central venous catheter - dressing change
  3. Cancer Research UK. PICC lines
  4. Macmillan Cancer Support. Implantable ports
  5. Macmillan Cancer Support. Central lines for chemotherapy and other drugs
  6. CDC. Guidelines for the Prevention of Intravascular Catheter-Related Infections
  7. MedlinePlus (U.S. National Library of Medicine). Peripherally inserted central catheter - dressing change
  8. MedlinePlus (U.S. National Library of Medicine). Histocompatibility antigen test
  9. National Cancer Institute (NCI). What Are Clinical Trials?
  10. NHS (UK). Chemotherapy
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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