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How To Care For Your Peripherally Inserted Central Catheter
A peripherally inserted central catheter (PICC)
is an IV placed into a large blood vessel near your heart. It is usually inserted through a blood vessel in your arm. Your PICC may have multiple ports. Ports are tubes where you can inject medicine. A PICC can stay in place for several weeks or months. You may need a PICC to get nutrition, medicine, or fluids. Blood samples can be removed from your PICC and sent to the lab for tests.
How a PICC is inserted:
- You may be given local anesthesia to numb the area. With local anesthesia you may feel pressure or pushing, but you should not feel any pain. Your healthcare provider will place a tight band around your arm. This helps your healthcare provider see your veins. Your healthcare provider will insert a needle into a vein in your arm. He will guide a wire through the needle into a larger vein near your heart. He may use ultrasound or x-ray pictures to place the wire in the correct place. When the wire is in the correct place, he will move a catheter over the wire.
- The needle and wire will be removed, and the catheter will be left in your vein. Healthcare providers may secure the catheter to your skin with a securement device or stitches. A bandage will be placed over your catheter. Your arm may be bruised, swollen, or sore after the procedure. This should get better in a few days. Rest as directed after your procedure. Do not lift anything heavier than 5 pounds. Do not bathe, swim, or drive until your healthcare provider says it is okay.
Call 911 for any of the following:
- You feel lightheaded, short of breath, and have chest pain.
- You cough up blood.
- You have trouble breathing.
Seek care immediately if:
- Blood soaks through your bandage.
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- You have trouble moving your arm.
- Your catheter falls out.
Contact your healthcare provider if:
- You have a fever or swelling, redness, pain, or pus where the catheter was inserted.
- You cannot flush your catheter, or you feel pain when you flush your catheter.
- You see a hole or crack in the tubing of your catheter.
- You see fluid leaking from the insertion site.
- You run out of supplies to care for your catheter.
- You have questions or concerns about your condition or care.
How to change your bandage and clean your skin:
Change your bandage every 7 days or as directed. Change the bandage any time it becomes wet, dirty, or moves out of place. Keep your 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 into your skin (insertion site). Scrub the area around the insertion site as directed. Start at the insertion site and clean outward from it in circles.
- Clean the tubing that comes out of your skin as directed.
- Place the pad that fits around the insertion site as directed. Place the securement device around your catheter as directed.
- Apply the bandage as directed. If the bandage is clear, make sure you can see the insertion site.
How to care for 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 on your catheter, close the clamps on each port. 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 healthcare provider may tell you to place protective caps over the injection caps. The caps will protect your 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 catheter when you get medicine. Ask your 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 the injection cap. Always place a cap over the end of medicine tubing when you are not using it.
How to flush your PICC:
Your healthcare provider will tell you how often to flush your catheter. He will also tell you how much saline or heparin to flush the catheter with. Always flush your catheter before and after you get medicine through it. Do the following to flush your 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.
- Attach the saline or heparin syringe to the injection cap. Open the clamp if your catheter has one.
- Slowly push on the plunger of the syringe to flush your catheter. Do not force the saline or heparin into your catheter. This could damage the catheter or your vein. Call your healthcare provider if you cannot flush your catheter.
- Detach the syringe and throw it away. Scrub the injection cap with an alcohol pad for 15 seconds.
Prevent a bloodstream infection:
- Wash your hands often. Wash your hands before and after you touch your 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 catheter. Only touch your catheter when you need to give yourself medicine or clean it. Do not let others touch your catheter or medicine tubing.
- Keep the tubing clamped when not in use. This will prevent air and water from getting into your catheter.
- Do not swim or take a bath. These actions can cause germs to get into your catheter.
- Cover your catheter with a waterproof cover before you shower. Ask your healthcare provider where to buy a waterproof cover. He may instead tell you to place a plastic bag or wrap over your catheter. Keep your catheter out of the water as much as possible. Change the bandage if it gets wet.
- Check your 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 healthcare provider right away.
- Ask your healthcare provider which activities are safe to do. Do not lift anything heavier than 10 pounds with your arm that has the catheter.
- Drink plenty of liquids. Liquids will help prevent dehydration and blood clots. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you.
- Tell healthcare providers that you have a catheter. Tell them not to do, IVs, blood draws, and blood pressure readings in the arm with your catheter. Do not allow flu shots or vaccinations in the arm with your catheter.
Follow up with your healthcare provider as directed:
Write down your questions so you remember to ask them during your visits.
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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.