HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 9-11
Infusion Therapy: Peripherally Inserted Central Catheter (PICC) Removal _RN
PURPOSE:
To establish safe guidelines for PICC removal.
CONSIDERATIONS:
1. Insertion, tip placement and removal of a PICC are
performed only when ordered by the physician.
2. Any breakage of a PICC line will result in immediate
removal or repair.
EQUIPMENT:
Gloves, sterile and non-sterile
2x2 gauze sponge, sterile
Antimicrobial ointment
Tape and/or bandaid
Suture Removal Kit (optional)
Disposable apron (optional)
Protective eye wear (optional)
Impervious trash bag
PROCEDURE:
1. Adhere to Universal Precautions.
2. Explain the procedure and purpose to the patient/caregiver.
3. Wash hands and assemble the equipment on a clean
surface, close to the patient.
4. Place patient in comfortable position, making sure that site
is accessible with arm at 90 o angle.
5. Ensure adequate lighting.
6. Don non-sterile gloves.
7. Place patient's arm at side, on a protective barrier. Remove
old dressing and discard appropriately. Cleanse site per
agency protocols.
8. Prepare PICC removal materials:
a. Open sterile glove field. Place sterile gauze on field.
b. Apply antiseptic ointment on center. If the catheter is
being removed due to possible infection and there is
purulent drainage from the insertion site do not apply
ointment or cleanse the area- until a sterile swab is
used to retrieve a specimen of the drainage.
c. Don sterile gloves.
d. Remove sutures if present.
e. Place the patient in a dorsal recumbent position with the
head of the bed flat and have him/her perform the
Valsalva maneuver while the catheter is being
withdrawn. These two motions will help reduce the
possibility of an air embolism when removing a central
venous catheter.
e. Grasp catheter at exit site and remove with slow steady
motion.
f. If resistance is felt, stop removing catheter and wait a
few moments, patient may be having venous spasms. If
this occurs the application of a warm, moist compress
may help relieve the venous spasm or vasoconstriction.
g. If resistance continues, place warm pack on arm,
(venous dilation) and wait 10 minutes.
h. If still unable to withdraw, apply sterile gauze at
insertion site and tape in place. Notify physician.
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