Caring for your Peripherally Inserted Central Catheter (PICC) Line for Parenteral Nutrition or Intravenous fluids

Patient Leaflets Team

  • Reference Number: HEY-635/2019
  • Departments: Nutrition Support

Introduction

This leaflet has been produced to give you general information on your treatment. Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion.  If after reading it you have any concerns or require any further explanation, please discuss this with a member of the healthcare team.

Caring for your Peripherally Inserted Central Catheter (PICC) line

Your Peripherally Inserted Central Catheter (PICC) line can remain in place for several months and in some cases PICC lines have been in place for up to a year or longer. If your PICC line is functioning and there have been no complications your line will not require routine replacement.

You will be trained how to care for your PICC line and observe for any complications. Depending on your individual care needs you may be able to care for your PICC line independently following training when you return home or we will arrange for our nutrition homecare team to complete your daily care.

Flushing the PICC line

Your PICC line will require flushing with 10 ml normal saline before each connection to Parenteral Nutrition (PN) or intravenous (IV) fluids and after the infusion has completed. This is to ensure the line remains free from blockages.

Please follow the connection and disconnection procedure you have been shown by your nurse. When your line is not in use there is a slight risk it may become blocked. To stop this happening when the line is not in use it will require weekly flushing.

Information about your PICC line

There are a number of securement devices used to keep your line secure. There are a number of securement devices used. Statlock®,Clinifix® and Securacath®. Your specialist nurse will select the appropriate fixing device for you.   You will be required to change your dressing, needle free device and securement device every 7 days unless you have a Securacath® device in place, this device is placed upon insertion and remains in place until the line is no longer required. Your specialist nurse will advise which device you have in place.

Your specialist nurse will show you how to do this safely. If you are unable to complete this, your homecare team will complete this for you.

Date of PICC line insertion ________ / ________ / ________________

Line type ________________________________________________

Single Lumen / Double Lumen (Circle)

PICC length at time of insertion __________ cm External cm length __________

Weekly Flush Mon / Tues / Weds/ Thurs/ Fri / Sat/ Sun (Circle)

Weekly dressing, needle free device and Statlock® fixation device change

M / T / W / T / F / S / Su (Circle)

Completing the dressing change

A transparent dressing will cover the PICC line and Statlock® fixation device; the dressing will initially be changed 24 hours after the procedure by the nurse caring for you.

The dressing will then require changing every 7 days unless required more frequently due to soiling or the dressing becoming loose.

General care

Your specialist nurse will go through your aftercare when planning discharge.

Care of the exit site

You will need to check the site daily for any swelling, redness or pain – contact your healthcare professional with any concerns.

You will be shown how to check the external length/measurement of the line to ensure the line has not moved out of place.

Soiled, wet or loose dressings

Your dressing, securement device and needle free device requires changing every 7 days unless the dressing becomes loose or the dressing is soiled.

Your specialist nurse will arrange your weekly dressing changes at home.

Bathing and showers

You can bathe and shower whilst you have your PICC line in place but you must take care not to immerse the line whilst bathing. Keep the line clean and the dressing dry by covering the entire line with an additional waterproof dressing.

Possible problems

If you have any concerns or notice any problems with your line, you should contact your nurse Monday to Friday between 7.00am to 4.00pm, or Ward 11 after 4.00pm.

Specialist Nurses via Switchboard (01482) 875875 ask for Bleep 771 CHH or ask for Bleep 640 HRI Mobiles: 07827 937025 or 07557 759863

After 4.00pm and on bank holidays and weekends, please contact Castle Hill Hospital – Ward 11 (01482) 623011.

Infection

It is possible for an infection to develop inside the line or in the area where it goes into the vein. If you notice any swelling or redness along the vein above the insertion site contact your nurse. If you feel generally unwell or feel like you have a temperature, contact your nurse.

Leaking of PN, blood or fluid

If you notice any leaking from the line a hole may have developed in your line or extension.

Line blocked/infusion stops

Your infusion of Parenteral Nutrition (PN) or Intravenous fluid (IVF) will not flow through the line. Or you are unable to flush using normal pressure. Report any difficulties flushing your line to your specialist nurse.

The PICC breaks or you accidentally cut the line

You notice a cut or tear in the line. Please ensure you keep scissors away from your PICC Line. Contact your specialist nurse who will arrange a repair or replacement of your line.

Movement of the line out of the vein (known as Migration)

You feel a sensation in your neck or chest when flushing the line. You may hear a flushing sound when flushing the line. The line appears longer, contact your nurse as your line may need to be repositioned.

Air in PICC line entering the bloodstream

If you suddenly have difficulty breathing, experience chest pain, dizziness or confusion, contact the emergency services. If possible, lie down with your head lower than your hips and feet, until assistance arrives.

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