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PICC Removal (102.007)

PICC Removal (102.007) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Central Lines

102.007

UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: PICC REMOVAL

Effective Date: September, 2003 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed January, 2008 May, 2009 June 2012


PURPOSE: To provide guidelines for the removal of a Peripherally Inserted Central Catheter from adult or
pediatric patients using appropriate infection control measures to prevent intravascular catheter-related
complications at UWMF & DFM Clinics.

DEFINITIONS:
Central venous catheters are used to give long-term medicine treatment for pain, infection, or cancer, or to supply
nutrition. A central venous catheter can be left in place far longer than a peripheral intravenous catheter (PIV), which
gives medication into a vein near the skin surface. The tip of all central venous catheters is in the superior vena cava
(SVC). There are several types of central venous catheters.
PICC line: (Groshong, Open-ended, Power) A peripherally inserted central catheter, or PICC line, is a central venous
catheter inserted into a vein in the arm and then threaded into the SVC.


PICC

POLICY: Nurses will utilize the following guidelines to properly remove a PICC from an adult or pediatric
patient.

SUPPLIES:
Sterile gauze 2 x 2s
Sterile scissors or suture removal kit (if catheter is sutured in place)
Alcohol pads
Gloves
Sterile occlusive dressing (2x2 gauze, Tegaderm® or Coban®)








PROCEDURE:

1. Verify MD order to discontinue catheter.

2. Verify length of catheter at time of insertion as documented in patient’s chart from facility where line was
inserted.

3. Explain procedure to patient.

4. Wash hand and gather equipment.

5. Inspect insertion site and general condition of cannulated arm and shoulder.

6. Open sterile packages (2x2’s, sterile scissors or suture removal kit, if needed).

7. Apply gloves.

8. Remove old dressing and discard in proper container.

9. Apply new pair of clean gloves.

10. If catheter is sutured, carefully cut suture and pull suture through skin.

11. Place 2x2 over insertion site with non-dominant hand.

12. Gently retract catheter smoothly and steadily until completely removed.
NOTE: If resistance occurs, stop procedure, secure catheter with tape, and notify the physician.

13. Immediately apply pressure with 2x2 over insertion for 2 minutes, or until bleeding stops. Once hemostasis
has been achieved, immediately apply an occlusive, sterile dressing over site.

14. Inspect the catheter tip for intactness. Measure removed catheter length and compare to length at time of
insertion as documented in patient’s chart.

15. Discard of catheter in biohazard waste container.

16. Patient instructions:
a) Observe dressing regularly for increased drainage or bleeding
b) Remove dressing after 24 hours and leave open to air
c) Call office if: redness, swelling, pain, drainage or bleeding at site

17. Documentation in Progress Notes section of HealthLink:
a) Patient education
b) Measurement of arm circumference, length of catheter at time of insertion
c) Condition of site
d) Procedure performed, date & time completed
e) Length of catheter after removal, condition of catheter tip
f) How the patient tolerated the procedure
g) Discharge instructions
h) Follow-up appointment (if any)




WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support

REVISED BY: Carol Decker, RN, MSN, Clinical Staff Educator, 2012

REVIEWED BY: LaVay Morrison,RN, BSN, Clinical Staff Educator, 2012
Shar Ballentine, RN, BSN, Clinical Program Coordinator, Chartwell Midwest Wisconsin
Susan Antonie, RN, Hematology/Oncolocgy Clinic, UWMF
Julie Nampel, RN, Clinic Mgr, Hematology/Oncology, UWMF & GYN/Med/Oncology, UWHC
Rebecca Harrison, RN, Urgent Care, Team Lead
Brian Tish, RN, Urgent Care, Team Lead


REFERENCES:
Infusion Nurses Society. (2006). Policies and procedures for infusion nursing. (3rd ed.). Infusion Nurses
Society.


AUTHORIZED BY: Richard Welnick, MD, Medical Director, UWMF Ambulatory Clinic Operations
Sandra A. Kamnetz M.D., Vice Chair, Department of Family Medicine


_______________________________________________________________________________
Medical Director, UWMF

________________________________________________________________________________
Vice Chair, Department of Family Medicine