Today I am going to give you tips about taking care of a peripherally inserted central catheter (PICC). PICC lines are normally inserted when use of Intra-Venous route is expected to go over 7 days.
PICC lines are my favorite access because unlike other central lines like subclavian and internal jugular central lines, PICC lines are more durable and not as delicate. Although PICC lines are more durable, they tend to clot easily and fail to give blood return easily than other central lines.
Here are some tips for taking care of a PICC line.
- Flush each port at least twice a shift. Use different 5cc or 10 cc syringe on each port to prevent cross contamination
- Use turbulence flushing technique. This simply means, you flush intermittently with a whole 10cc syringe. This creates good enough pressure to prevent red blood cells clumping causing clots and blocked ports.
- Never use less than 5 cc syringes on a PICC like or any other central line. To be on the safe side, always use 10cc syringe. The smaller the syringe, the higher the pressure it exerts on the ports and this can make the tip to break off and result in more serious damage like strokes and cardiac ischemia.
- Always verify that there is a date and an initial on the date the last dressing was done. If there is a bio-patch™, the PICC line dressing can be done every 7 days unless it is not intact or signs of infection are noticed.
- Always check your drugs compatibility to prevent drugs crystallization in the PICC causing blockage.
- When PICC line is not in use, always make sure one port has normal saline “to keep open” (TKO). This again is to prevent from blockage from red blood cells clumping together.
- When drawing blood from a PICC line, use turbulence technique (pull intermittently). This will not only prevent red blood cells clumping but it will also keep red blood cells intact. If you pull continuously and the pressure is high, the red blood cells will hemolyze, making it impossible to give accurate results on labs like CMP, BMP, CBC etc
- Incase of PICC line blockage, always notify the provider and/or PICC nurse. If not comfortable, do not try to de-clot using TPA. Some facilities does not allow use of TPA on PICC lines except by PICC line nurses or MD
- After removing a PICC line, always verify the tip is intact. Always make sure the measurements after removing the PICC corresponds with those documented on insertion date
- If your PICC line is not working, you have no reason keeping it. Remove it and follow your facility protocol. Most facility required culture done for the tip.
Enjoy the great convenience of a PICC LINE
Mary Mills says
Using a 5cc syringe to flush a VAD is not recommended as the increased pressure might cause damage to the VAD lumen.