An Overview of Peripherally Inserted Central Catheters

Leigh A. Bowe-Geddes, RN, BS, CRNI; Heather A. Nichols, RN, BSN, CRNI

Disclosures

Topics in Advanced Practice Nursing eJournal. 2005;5(3) 

In This Article

PICC Removal

Only clinicians who have been trained to manage potential complications should remove a PICC. One potential complication, often referred to as a "stuck PICC," occurs when the catheter fails to disengage during removal and cannot be pulled out of the vein. This is usually caused by venospasm and resolves with time. It is important not to continue to pull on the PICC if this occurs. The clinician should coil any exposed portion of the catheter, apply a sterile dressing, and allow time for the venospasm to resolve. Continuing to pull against the resistance will aggravate the venospasm. It also could cause the PICC to break, possibly leading to a life-threatening catheter embolus.

When removing a PICC, it is important to exert slow, intermittent traction without applying any direct pressure to the insertion site. The nurse must wear sterile gloves and pull the catheter out onto a sterile field, in case it becomes stuck and must be temporarily redressed. The nurse maintains the patient's arm below the level of the heart during removal. When the entire catheter has been withdrawn, the nurse should measure it carefully and compare this measurement to the documented insertion length. This safety practice verifies that the entire catheter was removed successfully. Finally, a sterile occlusive dressing is applied to the exit site and left in place for 24 hours.

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