From the Guidelines
Removing a PICC line should only be performed by a trained healthcare professional such as a nurse or physician, following proper protocols to minimize the risk of complications, as recommended by the most recent guidelines 1. The procedure involves first gathering supplies including sterile gloves, mask, sterile gauze, adhesive bandage, and a sterile container.
- The healthcare provider will wash their hands thoroughly and put on sterile gloves and a mask.
- They will then gently remove the dressing and any securing devices holding the PICC line in place.
- The patient should lie flat and be instructed to hold their breath or perform the Valsalva maneuver (bearing down as if having a bowel movement) while the line is steadily and smoothly pulled out to prevent air from entering the vein.
- Once removed, the healthcare provider will apply pressure to the site with sterile gauze for about 1-2 minutes until bleeding stops, then cover with an adhesive bandage.
- The site should be monitored for 24-48 hours for signs of infection or bleeding. PICC line removal by a professional is crucial because improper removal can lead to serious complications including air embolism, infection, bleeding, or catheter breakage, as highlighted in the guidelines 1.
- Patients should never attempt to remove a PICC line themselves.
- Before removal, it is essential to rule out other possible sources of infection and inspect the catheter insertion site for signs of local infection, as recommended by the guidelines 1.
- Blood cultures should be taken from the catheter and a peripheral vein for microbiological evaluation, if necessary, to ensure proper management of potential infections 1.
From the Research
Proper Removal of PICC Line
To properly remove a PICC line, it is essential to follow a standardized procedure to minimize the risk of complications.
- The removal process should be performed by a trained healthcare professional in a sterile environment.
- The patient should be positioned in a comfortable and stable position to prevent any accidental movement during the removal process.
- The PICC line should be removed using a gentle and steady motion, taking care not to pull or tug on the catheter.
- After removal, the site should be cleaned and dressed with a sterile dressing to prevent infection.
Complications Associated with PICC Line Removal
Complications can occur during or after PICC line removal, including:
- Catheter occlusion 2
- Catheter-related bloodstream infection 2, 3
- Symptomatic catheter-associated deep vein thrombosis (DVT) 3
- Exit site infection 2
Risk Factors for Complications
Certain risk factors can increase the likelihood of complications during or after PICC line removal, including: