Guide to PICC Maintenance

A central venous access device (CVAD) or central venous catheter (CVC) is commonly referred to as a central line. A central line is placed into the central venous vasculature and the CVAD tip is placed in the lower third of the superior vena cava or at the cavoatrial junction.

The PICC is a very small gauge catheter (3-6FR), typically 50 to 60 cm in length, inserted percutaneously into an upper extremity vein and then threaded to the superior vena cava (SVC) or cavoatrial junction (CAJ). This type of CVAD is used for short or long-term infusion therapies lasting from 7 days to months. 

PICCs come in a variety of configurations. Multi-lumen, valved, non-valved, distally or proximally valved, power injectable, antimicrobial and antiseptic catheters. Having manufacturer's directions and details can be a helpful tool in understanding the proper care and maintenance of the catheter being used. 
 
Please note: These lists are for reference and educational use only. Pedagogy does not recommend the use of any product or product manufacturer. 
 

Guide to PICC Maintenance

TASK HOW FREQUENCY WHY
Accessing
Connector / Cap
  • Scrub the hub thoroughly with alcohol for 15-30 seconds
  • Consider using disinfection caps
Every time you:
  • Enter the connector to flush,
  • Administer medication, or
  • Connect any tubing
Prevents outside bacteria from entering the line
Blood Draw Aseptic Technique
  • Slowly using 10mL or larger syringe
  • Flush with 10 mL NS before and 20mL NS after
Per Licensed Practitioner orders  or routine lab work Reduces needle sticks
Assess Need Evaluate the need for IV meds or fluids with the patient care team Every shift
  • Longer catheter dwell times lead to higher risk of infection
  • Remove catheter if not needed
Site
Evaluation
Observe site for signs of infection: redness, edema, drainage, tenderness, etc. Every shift and as needed Consistent monitoring leads to faster treatment of complications
Flushing /
Locking
  • Scrub the connector
  • Know manufacturer directions for flushing /clamp/syringe removal sequence
  • Use commercially prefilled 10mL size syringes
  • Do not force or push against resistance
  • Consider Push/Pause Technique
  • Before and after every medication
  • Before and after every blood draw
If not in use:
  • Non-valved: every 24 hours
  • Valved: once a week
  • Prevents incompatible fluids/medications from combining
  • Flush after each infusion to clear the catheter lumen
Needleless Access Device Change
  • Aseptic technique
  • Scrub the hub with alcohol
  • Change with admin set or every 7 days
  • After a lab draw
Prevents outside bacteria from entering the line
Dressing Change
  • Aseptic technique
  • Sterile dressing change kit
  • Use clear dressings (TSM) without gauze underneath; consider antimicrobial disc
  • Gauze and tape for patients with skin irritation
  • Securement device
  • Label date, time, initials
  • Every 7 days or when dressing is loose, wet, or soiled
  • Gauze dressings should be changed every 48 hours
  • Securement device should be changed with dressing
  • Antimicrobial disk with each dressing
  • Helps prevents infection
  • Clear dressing allows for visualization of the site
  • Securement device prevents catheter movement, dislodgement, and phlebitis
  • Label communicates dressing age
 
Are you a manufacturer of a PICC line product  that isn't listed here? Please contact us at support@pedagogy-inc.com and we would be more than happy to list your device as well. 

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