Can I remove a peripherally inserted central catheter (PICC) line at home if the patient is stable, has no signs of infection, is not actively bleeding, and is not on therapeutic anticoagulation unless cleared by a clinician?

PICC Line Removal at Home

Yes, a PICC line can be safely removed at home by an appropriately trained clinician when the patient is stable, has no signs of infection, is not actively bleeding, and therapeutic anticoagulation is not a contraindication to removal. 1

Who Can Perform Home PICC Removal

Only clinicians specifically trained in PICC removal should perform this procedure—training in central venous catheter (CVC) removal alone is insufficient and considered inappropriate. 1 A physician order is mandatory before any PICC removal. 1

Pre-Removal Assessment

Before proceeding with home removal, verify:

• The PICC is no longer clinically necessary (therapy completed, unused for ≥48 hours, or used only for phlebotomy when adequate peripheral veins exist) 1
• No signs of active infection at the exit site (erythema, purulence, warmth) or systemically (fever, chills) 2
• No persistent bleeding from the site 1
• Anticoagulation status is documented—therapeutic anticoagulation is NOT a contraindication to removal, but requires awareness for extended pressure application 1

Home Removal Technique

Patient Positioning

• Position the patient supine with the exit site below heart level to minimize air embolism risk 1, 3
• Extend the arm fully to facilitate safe catheter withdrawal 1

Antiseptic Preparation

• Use chlorhexidine-alcohol solution for skin antisepsis at the exit site 1
• Allow the antiseptic to dry completely before proceeding 1
• Remove any stabilization devices (e.g., Statlock) securing the catheter 1

Removal Procedure

• Wear sterile gloves and maintain strict aseptic technique throughout 1
• Apply gentle, steady traction to withdraw the catheter—never use excessive force 1
• If resistance is encountered, STOP immediately—do not force removal, as this risks catheter breakage or vascular injury 1, 4
• Consult vascular surgery or interventional radiology if the catheter cannot be removed with gentle traction 1, 4

Post-Removal Care

• Inspect the entire catheter to confirm it is intact and complete 1, 4
• Apply firm digital pressure for at least 5 minutes (longer if on anticoagulation) until hemostasis is achieved 1, 3
• Place a sterile occlusive dressing over the exit site 1, 3
• If bleeding persists despite adequate pressure, a skin stitch may be required—this may necessitate transfer to a facility 1, 3
• Document the procedure, including exit site condition, catheter integrity, and any complications 1

Special Considerations for Anticoagulated Patients

Therapeutic anticoagulation is NOT a contraindication to PICC removal. 1 Standard hemostasis with firm pressure for ≥5 minutes is sufficient, though you may need to apply pressure longer in anticoagulated patients. 1 For patients with PICC-related DVT on anticoagulation, removal is appropriate when symptoms persist despite ≥72 hours of therapeutic anticoagulation, or when the PICC is no longer clinically necessary. 1

Critical Pitfalls to Avoid

• Never advance a migrated or partially withdrawn PICC back into position—this is rated inappropriate 1
• Never forcefully pull a resistant PICC—catheter breakage can lead to retained fragments requiring surgical or interventional retrieval 1, 4, 5
• Never remove a PICC without a physician order 1
• Never allow removal by someone trained only in CVC removal but not specifically in PICC removal 1, 4
• Do not remove a PICC that is still needed for vesicant/irritant infusions even if DVT is present 1

When Home Removal Is NOT Appropriate

Transfer to a facility or defer removal if:

• Signs of infection are present (purulence, erythema, fever)—obtain cultures before removal 2, 1, 4
• The catheter cannot be removed with gentle traction—requires interventional radiology or vascular surgery consultation 1, 4
• Active uncontrolled bleeding is present at the exit site 1
• The patient develops symptoms of air embolism during or after removal (dyspnea, chest pain, altered mental status) 3