About PICC Lines from VAM
Specializing in all aspects of:
Peripherally
Inserted
Central
Catheters
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Caring for Your
PICC Line:
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.
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