What Patients Need to Know
Peripherally inserted central catheter is a form of IV access. The catheter is inserted in a vein usually located in the arm with the catheter tip terminating in a large vein close to the heart. While in the hospital, nurses will care for the PICC line. They will assess the insertion site, inspect the dressing, check for leakage, perform flushing maintenance and act according to the outcomes. The PICC can be a long term IV access device and patients may be discharged home with the PICC in place to continue with treatments instead of requiring additional hospitalization. Therefore, the patient must be informed of general PICC line care so he is comfortable with it and is aware of circumstances that require alerting healthcare professionals of possible complication.
Preventing Infection & Dressing Changes:
- A secure, clean and intact dressing is essential to prevent catheter migration and infection. The dressing should be changed every seven days or more if needed. It is often helpful if a friend or family member is taught how to change the dressing, even if home care is used, to insure the dressing remains dry as a moist dressing is the perfect breeding ground for infection.
- When dressing changes are being done, insure that the anchoring devise, Biopatch and injection caps are also changed at that time.
- Dressings should be inspected daily. If it is wet, soiled or leaking, it must be changed. Dressings should be removed by loosening the adhesive, using alcohol if necessary. Scissors should never be used due to the possibility of cutting the catheter in error.
- Hands should be washed properly with an antiseptic solution prior to handling the catheter or supplies. Scrub hands thoroughly. Be sure to include the palms back of hands, fingers and spaces between them and fingernails. Rinse them with running water with hands pointing down so the water flows downward. Dry them with a dry paper towel.
- Clean the catheter caps with alcohol swab pads prior and post each use.
Flushing & Catheter Care:
- The cathether must be flushed every 12 hours and after each use. This is required to prevent clogging of the catheter. Flushing is done with 0.9% normal saline and heparin. Some catheters, however, are considered "saline only". They do not have clamps and do not require heparin for flushing.
- If flushing is difficult, this indicates that the PICC is becoming blocked. If it becomes fully blocked, it may not be usable. Report this difficulty in flushing immediately so it can be declotted to regain full functional use.
- The clamp of the catheter should be closed when not in use. If clamps are not present on the catheter, it is a "saline only" PICC lines which do not have clamps and do not require flushing with heparin following the flush with normal saline.
- The PICC dressing should not get wet. It must remain dry to prevent infection. During bathing, the likelihood water will come in contact with the dressing is greatly increased. Therefore, the PICC should be covered with a waterproof covering such as plastic wrap to prevent this from occurring.
- Blood pressure readings in the arm cannulated with the PICC should be avoided.
- The arm with the PICC line must not be babied. Normal use, in fact increases blood circulation in that arm. This aids in carrying medications to the heart for systemic circulation. However, strenuous work, lifting objects greater than ten pounds, or repetitive motion should all be avoided.
- Never pull on the catheter. Protect the lumens so they do not inadvertently get caught or tugged on.
- Inspect the site daily for any irregularities, such as swelling, redness, leakage or pain. If any irregularities or complications are noted, report them to a healthcare professional immediately.
- If the catheter breaks, whether bleeding does or does not occur, do not panic. Using sterile gauze, apply sufficient pressure at the site so it is tightly and well covered and immediately report this to the physician. Maintain pressure on the site at all times.
Supplies:
All supply packages should be inspected properly to insure they are completely sealed and dry. If there is any leakage from intravenous fluids and medications, they should not be used. Packages and items required for PICC dressing changes that have broken seal or tears, likewise, should not be used for this sterile procedure.
A clean, dry work area should be identified to complete medication preparations and perform dressing changes. The area must be without a draft which is essential for the sterile requirements during dressing changes. It is perhaps best for it to be an area that is without distraction, quiet, and comfortable.
Keep sterile supplies separate from non-sterile supplies.
Used syringes and IV bags should be disposed of properly.
Prior to discharge from any health care facility, arrangements will be completed to make the transition as easy as possible. A wallet size identification card should be provided to you which details specifics concerning the PICC line. Be sure to keeps this with you until the the PICC line is removed. After discharge, a home care service provider or infusion center will assist with education, care and maintenance of the PICC. Continued full use of the PICC line for the remaining treatment time with little to no complications can be obtained by following guidelines such as these and working with home health care professionals.
The consumer health information on this Website is for informational and educational purposes only and is not a substitute for medical advice or treatment for any medical conditions.