Removing a PICC Line
When the peripherally inserted central catheter is no longer required it is removed similar to an peripheral catheter. It is also discontinued when the patient develops catheter complications such as infection, damage, or blocked. It is a painless procedure that takes only a few minutes and can easily be completed as an outpatient procedure, usually by a trained nurse.
Only clinicians or nurses who have been trained to manage potential complications should remove a PICC. PICC removal can be accomplished either at the hospital or at a home setting by a qualified person. A physician's order must be obtained prior to removing a PICC. While removing, it is vital to exert slow, intermittent traction without applying any direct pressure at the insertion site.
During the removal process, there is possibility that resistance may be present. This could be caused by a venous spasm. Warmth often relieves the spasm and after a brief period of time may easily be removed. But the catheter must never be forcefully tugged as this could break it. If still unable to remove it easily, the physician should be notified.
After it is completely removed, the actual catheter length should be measured and compared with the documented insertion length. The documented and actual length must be equal as this is the only way to confirm that the catheter has not broken and has been removed intact. If the length of the removed catheter is less than the documented insertion length, it indicates that part of the catheter is retained inside the vein and the physician must be notified immediately.
In addition, the catheter tip should also be examined to insure there is no breakage at the end. Again, if the tip is not intact, immediately notify the physician.
If infection is suspected, then the tip of the catheter is sent for culture. A prior order from the physician should be obtained before sending the tip for culture.
After removing the catheter, gentle pressure is applied at the insertion site with sterile gauze to prevent bleeding which is typically minimal, if at all. When the bleeding stops, the gauze is removed and a sterile dressing is applied. The dressing should remain for approximately 24 hours. After this time, the site should be assessed and a new dressing applied if needed.
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