- Inspect catheter and insertion site
- Assess pain
- Change dressing and clean according to institution policies
- Transparent semipermeable dressing or gauze dressing
- Chlorhexidine preferred cleansing agent
- Change injection caps
- Have patient turn head to opposite side
- Valsalva if no clamp
- Flushing is important
- Normal saline prefilled syringe
- Use only 10 ml syringe or larger
- Push-pause technique
- Should be done according to institution policy
- Gently withdraw while patient performs the Valsalva maneuver
- Apply pressure
- Ensure that catheter tip is intact
- Apply antiseptic ointment and dressing
Things to consider to teach the patient with a PICC line
- Proper technique for cleansing port prior to access
- Proper flushing technique
- How to administer antibiotic
- S/S of occlusion and infection to monitor for
- Who to call if symptoms of occlusion and infection
- Importance of clamping catheter and keeping cap connection secure
- What to do if catheter is inadvertently open to air
How to remove a PICC line
- Put on nonsterile gloves and remove dressing.
- Don sterile gloves and mask; have patient turn head to other side.
- Remove sutures if present.
- Slowly and steadily withdraw catheter. If resistance is met, STOP.
- If resistance is met—can apply warm compresses for 20 minutes and retry. If resistance continues, notify HCP.
- Have patient perform the Valsalva maneuver as the last 5 to 10 cm of the catheter is withdrawn.
- Pressure should be immediately applied to the site with sterile gauze to prevent air from entering and to control bleeding.
- Inspect the catheter tip to determine that it is intact.
- After bleeding has stopped, apply an antiseptic ointment and sterile dressing to the site.