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How To Care For Your Child's Peripherally Inserted Central Catheter

WHAT YOU NEED TO KNOW:

What do I need to know about a peripherally inserted central catheter (PICC)?

A PICC is an IV placed into a large blood vessel near your child's heart. It is usually inserted through a blood vessel in his or her arm. Your child's PICC may have multiple ports. Ports are tubes where medicine can be given. A PICC can stay in place for several weeks or months. Your child may need a PICC to get nutrition, medicine, or fluids. Blood samples can be removed from his or her PICC and sent to the lab for tests.

How is a PICC inserted?

  • Your child may be given medicine to help him or her relax. He or she may also be given local anesthesia to numb the area. With local anesthesia he or she may feel pressure or pushing, but he or she should not feel any pain. Your child's healthcare provider will place a tight band around his or her arm. This helps his or her healthcare provider see his or her veins.
  • Your child's healthcare provider will insert a needle into a vein in his or her arm. He or she will guide a wire through the needle into a larger vein near your child's heart. Your child's healthcare provider may use ultrasound or x-ray pictures to place the wire in the correct place. When the wire is in the correct place, he or she will move a catheter over the wire.
  • The needle and wire will be removed, and the catheter will be left in your child's vein. Healthcare providers may secure the catheter to your child's skin with a securement device or stitches. A bandage will be placed over his or her catheter. Your child's arm may be bruised, swollen, or sore after the procedure. This should get better within a few days. Have your child rest as directed after the procedure. Do not let your child lift anything heavier than 5 pounds. Do not let your child bathe or swim, until his or her healthcare provider says it is okay.

How do I change the bandage and clean my child's skin?

Change your child's bandage every 7 days or as directed. Change the bandage any time it becomes wet, dirty, or moves out of place. Keep your child's catheter covered with a bandage at all times.

  • Get a bandage kit and place it on a clean surface.
  • Wash your hands with soap and water or use an alcohol-based hand rub.
  • Put on clean gloves and a mask. If someone else is helping you, that person also needs to wear a mask and gloves.
  • Carefully remove the old bandage and securement device. Remove your gloves and throw them away.
  • Wash your hands with soap and water or use an alcohol-based hand rub.
  • Open the bandage kit with the folded side facing up. Carefully unfold the corners of the bandage kit. Do not touch anything inside of the bandage kit. Everything inside of the bandage kit is sterile.
  • Pick up each glove by the folded part and put them on. Do not touch the outside of the gloves with your bare hand. Do not let them touch anything that is not sterile.
  • Open the cleaning pads and lay them on the bandage kit.
  • Use the cleaning pads to scrub the area where the catheter is inserted (insertion site) as directed. Clean the area around it as directed. Start at the insertion site and clean outward from it in circles.
  • Clean the tubing that comes out of your child's skin as directed.
  • Place the pad that fits around the insertion site as directed. Place the securement device around your child's catheter as directed.
  • Apply the bandage as directed. If the bandage is clear, make sure you can see the insertion site.

How do I care for the caps and tubing?

  • Clean the injection cap before and after each use. Wash your hands and put on gloves before you clean each injection cap. Hold the catheter above the cap with 1 hand. Scrub the injection cap with an alcohol pad for 15 seconds.
  • Change the injection caps every 3 to 7 days or as directed. Wash your hands and put on gloves before you change the caps. If there are clamps, close the clamps on each port of your child's catheter. Twist the caps to remove them from the end of each port. Scrub the end of each port with an alcohol pad for 15 seconds. Place a new cap on the end of each port. Your child's healthcare provider may tell you to place protective caps over the injection caps. The caps will protect his or her catheter from infection when it is not being used.
  • Change and clean the medicine tubing as directed. You may need to attach extra tubing to your child's catheter to give him or her medicine. Ask your child's healthcare provider how often to change medicine tubing. Wash your hands and put on gloves before you touch medicine tubing. Wipe the end of the tubing with an alcohol wipe before you attach it to the injection cap. Always place a cap over the end of medicine tubing when you are not using it.

How do I flush my child's PICC?

Your child's healthcare provider will tell you how often to flush his or her catheter. He or she will also tell you how much saline or heparin to flush the catheter with. If your child's catheter has multiple ports, you will need to flush each one. Always flush your child's catheter before and after you give him or her medicine. Do the following to flush your child's catheter:

  • Wash your hands with soap and water or an alcohol-based hand rub. Put on clean gloves.
  • Scrub the injection cap with an alcohol pad for 15 seconds.
  • Push on the end of the empty syringe so the plunger goes all the way to the tip. This will remove any air that is in the syringe. It is important to prevent air from being injected through the PICC.
  • Attach the saline or heparin syringe to the injection cap. Open the clamp if your child's catheter has one.
  • Slowly push on the plunger of the syringe to flush his or her catheter. Do not force the saline or heparin into his or her catheter. This could damage the catheter or his or her vein. Call your child's healthcare provider if you cannot flush his or her catheter.
  • Detach the syringe and throw it away. Scrub the injection cap with an alcohol pad for 15 seconds.

What can I do to prevent a bloodstream infection?

  • Wash your hands and your child's hands often. Wash your hands before and after you touch your child's catheter. Use soap and water or an alcohol-based hand rub. Tell others to wash their hands before and after they visit. This will decrease germs in your home.
  • Limit contact with your child's catheter. Tell your child not to touch his or her catheter. Touch your child's catheter only when you need to give him or her medicine or clean it. Do not let others touch your child's catheter or medicine tubing.
  • Keep the tubing clamped when not in use. This will prevent air and water from getting into your child's catheter.
  • Do not let your child swim or take a bath. These actions can cause germs to get into your child's catheter. Your child can shower or take a sponge bath.
  • Cover your child's catheter with a waterproof cover before he or she showers. Ask his or her healthcare provider where to buy a waterproof cover. He or she may instead tell you to place a plastic bag or wrap over your child's catheter. Tell your child to keep the catheter out of the water as much as possible.
  • Check your child's catheter every day for signs of infection. Look for redness, swelling, pus, or fluid. Report any pain at the insertion site or signs of infection to your child's healthcare provider. A fever may also be a sign of infection.

What can I do to care for my child?

  • Ask your child's healthcare provider which activities are safe for him or her. Do not let your child lift anything heavier than 5 pounds.
  • Give your child plenty of liquids. Liquids will help prevent dehydration and blood clots. Ask your child's healthcare provider how much liquid to give him or her each day and which liquids are best for him or her.
  • Tell your child's healthcare providers that he or she has a catheter. Tell them not to do IVs, blood draws, or blood pressure readings in his or her arm with the catheter. Do not allow flu shots or vaccinations in his or her arm with the catheter.

Call 911 for any of the following:

  • Your child feels lightheaded, short of breath, or has chest pain.
  • Your child coughs up blood.
  • Your child has trouble breathing.

When should I seek immediate care?

  • Blood soaks through your child's bandage.
  • Your child's arm or leg feels warm, or painful and is larger than usual.
  • Your child has trouble moving his or her arm.
  • Your child's catheter falls out.

When should I contact my child's healthcare provider?

  • Your child has a fever.
  • Your child has swelling, redness, pain, or pus where the catheter was inserted.
  • You cannot flush your child's catheter, or your child says he or she has pain when you flush his or her catheter.
  • You see a hole or crack in the tubing of your child's catheter.
  • You see fluid leaking from the insertion site.
  • You run out of supplies to care for your child's catheter.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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