PICC Home Care Guide

A peripherally inserted central catheter (PICC) is a form of IV access that allows medicines and IV fluids to be quickly put into the blood and spread throughout the body. The PICC is a long, thin, flexible tube (catheter) that is put into a vein in a person's arm or leg. The catheter ends in a large vein just outside the heart called the superior vena cava (SVC). After the PICC is put in, a chest X-ray may be done to make sure that it is in the right place.

• To give medicines and liquid nutrition.
• To give IV fluids and blood products.
• To take blood samples often.
• If there is trouble placing a peripheral intravenous (PIV) catheter.

If cared for properly, a PICC can remain in place for many months. Having a PICC can allow you to go home from the hospital sooner and continue treatment at home. Medicines and PICC care can be managed at home by a family member, caregiver, or home health care team.

What are the risks?

• A blood clot (thrombus) forming in or at the end of the PICC.
• A blood clot forming in a vein (deep vein thrombosis) or traveling to the lung (pulmonary embolism).
• Inflammation of the vein (phlebitis) in which the PICC is placed.
• Infection at the insertion site or in the blood. Blood infections from central lines, like PICCs, can be serious and often require a hospital stay.
• PICC malposition, or PICC movement or poor placement.
• A break or cut in the PICC. Do not use scissors near the PICC.
• Nerve or tendon irritation or injury during PICC insertion.

How to care for your PICC

Please follow the specific guidelines provided by your health care provider.

Preventing infection

• You and any caregivers should wash your hands often with soap and water for at least 20 seconds. Wash hands:
  • Before touching the PICC or the infusion device.
  • Before changing a bandage (dressing). Do not change the dressing unless you have been taught to do so and have shown you are able to change it safely.
• Flush the PICC as told. Tell your health care provider right away if the PICC is hard to flush or does not flush. Do not use force to flush the PICC.
• Use clean and germ-free (sterile) supplies only. Keep the supplies in a dry place. Do not reuse needles, syringes, or any other supplies. Reusing supplies can lead to infection.
• Keep the PICC dressing dry and secure it with tape if the edges stop sticking to your skin.
• Check your PICC insertion site every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Preventing other problems

• Do not use a syringe that is less than 10 mL to flush the PICC.
• Do not have your blood pressure checked on the arm in which the PICC is placed.
• Do not ever pull or tug on the PICC. Keep it secured to your arm with tape or a stretch wrap when not in use.
• Do not take the PICC out yourself. Only a trained health care provider should remove the PICC.
• Keep pets and children away from your PICC.

How to care for your PICC dressing

• Keep your PICC dressing clean and dry to prevent infection.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths. When you are allowed to shower:
  • Ask your health care provider to teach you how to wrap the PICC.
  • Cover the PICC with clear plastic wrap and tape to keep it dry while showering.
• Follow instructions from your health care provider about how to take care of your insertion site and dressing. Make sure you:
  • Wash your hands with soap and water for at least 20 seconds before and after you change your dressing. If soap and water are not available, use hand sanitizer.
  • Change your dressing only if taught to do so by your health care provider. Your PICC dressing needs to be changed if it becomes loose or wet.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.

Follow these instructions at home:

Disposal of supplies

• Throw away any syringes in a disposal container that is meant for sharp items (sharps container). You can buy a sharps container from a pharmacy, or you can make one by using an empty, hard plastic bottle with a lid.
• Place any used dressings or infusion bags into a plastic bag. Throw that bag in the trash.

General instructions

• Always carry your PICC identification card or wear a medical alert bracelet.
• Keep the tube clamped at all times, unless it is being used.
• Always carry a smooth-edge clamp with you to clamp the PICC if it breaks.
• Do not use scissors or sharp objects near the tube.
• You may bend your arm and move it freely. If your PICC is near or at the bend of your elbow, avoid activity with repeated motion at the elbow.
• Avoid lifting heavy objects as told by your health care provider.
• Keep all follow-up visits. This is important. You will need to have your PICC dressing changed at least once a week.

Contact a health care provider if:

• You have pain in your arm, ear, face, or teeth.
• You have a fever or chills.
• You have redness, swelling, or pain around the insertion site.
• You have fluid or blood coming from the insertion site.
• Your insertion site feels warm to the touch.
• You have pus or a bad smell coming from the insertion site.
• Your skin feels hard and raised around the insertion site.
• Your PICC dressing has gotten wet or is coming off and you have not been taught how to change it.

Get help right away if:

• You have problems with your PICC, such as your PICC:
  • Was tugged or pulled and has partially come out. Do not push the PICC back in.
  • Cannot be flushed, is hard to flush, or leaks around the insertion site when it is flushed.
  • Makes a flushing sound when it is flushed.
  • Appears to have a hole or tear.
  • Is accidentally pulled all the way out. If this happens, cover the insertion site with a gauze dressing. Do not throw the PICC away. Your health care provider will need to check it to be sure the entire catheter came out.
• You feel your heart racing or skipping beats, or you have chest pain.
• You have shortness of breath or trouble breathing.
• You have swelling, redness, warmth, or pain in the arm in which the PICC is placed.
• You have a red streak going up your arm that starts under the PICC dressing.

• Do not wait to see if the symptoms will go away.
• Do not drive yourself to the hospital.

Summary

• A peripherally inserted central catheter (PICC) is a long, thin, flexible tube (catheter) that is put into a vein in the arm or leg.
• If cared for properly, a PICC can remain in place for many months. Having a PICC can allow you to go home from the hospital sooner and continue treatment at home.
• The PICC is inserted using a germ-free (sterile) technique by a specially trained health care provider. Only a trained health care provider should remove it.
• Do not have your blood pressure checked on the arm in which your PICC is placed.
• Always keep your PICC identification card with you.