Clinical interventions and line care

The Clinical Interventions service is on Level 1 of Clatterbridge Cancer Centre – Liverpool. 

A PICC line is a long, thin, flexible tube which is inserted in a large vein in your upper arm. It follows the path of your vein and sits in a big vein above your heart. This is considered to be a very safe procedure. 

You will be referred to Clinical Interventions if your medical team feel a PICC line is the safest device for your treatment. A PICC can stay in place until you complete your treatment and does not need to be replaced routinely. You do not need to have blood tests before having a PICC line inserted. You can eat, drink and take your usual medications.

We will discuss the risks and benefits of a PICC line during your appointment and ask for verbal consent before we proceed. You can bring a friend or relative to this appointment but they will need to sit in the waiting room while your PICC line is inserted. 

If you need blood tests on the same day that your PICC line is inserted, let a member of staff know. We can take blood samples using your PICC line so you don’t need a separate appointment for your blood tests.  

You should ideally have your PICC line inserted as close as possible to your chemotherapy start date. This reduces the risk of complications. 

If your PICC appointment is booked too far ahead of your chemotherapy, we will need to rearrange it. Tell the Clinical Interventions team if you think your appointment date might be too many days before you start chemotherapy and we will be happy to rearrange it for you. 

Unfortunately, we cannot place PICC lines if you are currently on antibiotics for an active infection – there is a risk you could develop a further infection in your PICC line. 

This does not mean you will not be able to start chemotherapy. If you are unwell or on antibiotics:

• Call the Clinical Interventions team for advice on 0151 556 5737 between 8:00 and 4:00pm (08:00-16:00), Monday to Friday

A TIVAD is a long, flexible tube which is inserted into a large vein in your upper arm. The line sits in a big vein above your heart and is connected to a small injection port which is underneath your skin. 

The Portacath can be used for treatment and for taking blood samples. Portacaths can stay in place until you complete your treatment. 

Once healed, Portacaths do not need to be kept dry and they require very little maintenance. Portacaths are managed as part of your treatments – or every eight to 12 weeks if you are having a break from treatment. This offers flexibility to patients who want to continue with activities such as swimming. It also means you don’t need to come to hospital for line maintenance between treatments. 

Portacath insertions are a surgical procedure so will only benefit people on longer-term treatment. As a general rule, we will offer this device to patients who are on IV treatment for longer than six months. 

You are welcome to bring a friend or relative to your assessment appointment. During this appointment, we will ask you to sign a written consent form (if appropriate). We will also review your current medication and tell you if you need to stop or reduce medications that help keep your blood from clotting.

Not everyone is suitable for a Portacath – it depends on your treatment plan and your body anatomy. We will always offer you the most suitable device for your needs and refer you to other teams that can help you if necessary. 

We can support patients with specialist equipment who experience difficulties having blood tests or who have veins that are hard to find. Appointment are possible for urgent needs. Often a PICC or a Portacath is the best option when intravenous access is difficult. 

Our Phlebotomy (blood tests) team offer a very skilled service for patients who need blood samples. They have equipment that uses infrared light to help find veins in people who have problems with this. On the rare occasion they’re unable to take your blood samples, we will assess how we can help. 

Your chemotherapy nurse will usually insert your cannula for treatment. Unfortunately, ultrasound longer length deep access cannulas are not suitable for chemotherapy. This is because they sit too deep in your veins for staff to identify chemotherapy leakages in a timely manner. 

If your chemotherapy nurse is unable to cannulate you for treatment, you will be referred to Clinical Interventions for assessment. We will be able to discuss the safest device for your treatment. 

Your chemotherapy nurse can remove your PICC line after treatment. You do not need to come back to Clinical Interventions for this. 

We remove both chest and arm Portacaths. You will need blood tests before having a Portacath removed. We will also need to stop any anti-coagulation medication – blood-thinning medicine to help stop your blood from clotting. We will discuss this with you. 

We help with the removal of Hickman lines. In some cases, a doctor will do this. If the Clinical Interventions team are removing your Hickman line, you will need blood tests before this. We will also talk to you about stopping blood-thinning (anti-coagulation) medicine. 

Clinical Interventions Lead Nurse 

• Carol McCormick

Deputy Lead Nurse

• Ann Marie Brown

Clinical Interventions Nurse Specialists

• Jade Smith 
• Anna Hall
• Sarah Gallagher
• Stephanie Williams
• Valentine Irimia

We will occasionally have student nurses or medical staff observing procedures. We will always ask your permission to check you are comfortable with this. Please let us know if you would prefer to have fewer people in the room.