Peripherally Inserted Central Catheter (PICC): Care Instructions

Overview

A peripherally inserted central catheter (PICC) is a thin, flexible tube that's used to give medicine, blood products, nutrients, or fluids. One end is put through the skin into a vein in the arm and moved into a large vein near your heart. The other end stays outside your body. It is a type of central vascular access device, or central line. You may have it for weeks or months.

A PICC can be more comfortable for you because medicines and other fluids go directly into the catheter. So you won't be poked with a needle every time. A PICC also can be used to do blood tests.

A PICC may have two or three ends, called lumens, so that you can get more than one type of fluid or medicine at a time. The end of each lumen is covered with a cap.

Your doctor may give you medicine to make you feel relaxed. You may feel a little pain when your doctor numbs your arm. Your doctor will then put the PICC in your arm. You will not feel any pain. The doctor may use stitches or other devices to hold the PICC in place on your arm.

After the procedure, the site may be sore for a day or two. You may have a large bandage or other covering to help keep the PICC clean and in place.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Always wash your hands with soap and water before you touch your PICC.
• To help prevent infection, take a shower instead of a bath. When you shower, cover the device with waterproof material, such as plastic wrap. Do not go swimming with a PICC.
• Keep the dressing clean and dry. If you were given instructions about how to change the dressing at home, follow those instructions carefully.
• If your PICC has a clamp, keep it clamped when you are not using it.
• Be careful wearing jewelry, such as necklaces, that can catch on the PICC.
• Avoid clothing that rubs or pulls on your PICC.
• Talk to your doctor about what activities you can do. You may not be able to do sports or exercises that use the upper body, such as tennis or weight lifting.
• Never touch the open end of the PICC if the cap is off.
• Never use scissors, knives, pins, or other sharp objects near the PICC or other tubing.
• Fasten or tape the PICC to your body to prevent it from dangling and being pulled on.
• Avoid bending or crimping it.
• Clamp off the PICC if it breaks. Then go see a doctor as soon as possible.
• Your PICC will need regular flushing to keep it open. Your care team may do this for you. You or a caregiver can be taught to do this at home. Be sure to follow those instructions carefully.
• Check it every day for symptoms of infection. These include pain, tenderness, swelling, drainage, pus, redness, or warmth on the skin near the device.
• Don't have your blood pressure taken on the arm with the catheter.
• Carry a medical alert card with you, and consider wearing a medical alert bracelet. These will tell health care providers you have a PICC in case you need emergency care.

How do you change the dressing?

Since the PICC is in one of your arms, you won't be able to change the dressing on your own. You'll need someone to help you change the dressing. Your care team can teach you and a caregiver to do this at home.

If you have a gauze dressing, change it every 2 days. If it's a clear plastic dressing, change it every 7 days. Also change the dressing if it is wet, bloody, loose, or dirty. Your care team may also give you specific instructions on how and when to change the dressing.

Be sure you have all your supplies ready. These include medical tape, a surgical mask, clean disposable gloves, sterile gloves, the dressing, an applicator, alcohol pads, and skin-protecting swabs. The names and brands of the items will vary.

Here are basic tips for how to change the dressing.

1. Prepare a clean work area, such as a clean counter in your bathroom. Put your supplies on the clean area.
2. Wash your hands with soap and water for at least 20 seconds. Be sure to wash between your fingers and under your fingernails. Dry them with paper towels.
3. Put on the surgical mask.
4. Put on the clean disposable gloves. Loosen and slowly peel away the old dressing while holding the PICC securely in place. You may need to use an adhesive remover if it doesn't come off easily.
5. Look at the site carefully for redness, swelling, drainage, pus, tenderness, or warmth. If you notice any of these, contact your doctor.
6. Remove your disposable gloves.
7. Wash your hands again (as instructed in step 2), and put on the sterile gloves.
8. Clean the area. Use the applicator the care team gave you, or use alcohol pads. Clean in an up-and-down or side-to-side motion. When you have finished, let the area dry for about 30 seconds.
9. Clean the outside of the PICC.
   • Use an alcohol pad to hold the PICC in place. Use another alcohol pad to gently clean the outside of it.
   • Start from where the PICC is at the skin and gently clean toward the cap.
   • If the PICC has 2 or 3 lines, use a fresh pad to clean each line.
10. Swab the edges of the cleaned area with the skin protector.
11. Remove the backing from the clear plastic dressing. Place the dressing over the PICC and the skin around it. If you are using a gauze dressing, be sure it covers the skin around the PICC and secure it with tape.
12. Tape or fasten the PICC to your child's body so it won't dangle or get pulled on.
13. Dispose of the old dressing and any used materials as instructed.
14. Wash your hands again with soap and water.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).
• You have severe trouble breathing.
• You have sudden chest pain and shortness of breath, or you cough up blood.
• You have a fast or uneven pulse.

Contact your doctor now or seek immediate medical care if:

• You have symptoms of infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.
• You have blood draining from the area near the PICC.
• You have swelling in your face, chest, neck, or arm on the side where the PICC is.
• You have symptoms of a blood clot, such as bulging veins in the neck.
• Your PICC is leaking, cracked, or clogged.
• You feel resistance when you inject medicine or fluids into your PICC.
• Your PICC is out of place. This may happen after severe coughing or vomiting, or if you pull on it.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.