Home Care for Peripherally Inserted Central Catheters (PICC Line)

A PICC line is a thin, flexible tube that will be inserted into a vein in the upper portion of the arm.

Why Do I Need a PICC Line?

Your doctors and healthcare providers have determined that you are a candidate for a peripherally inserted central catheter (also called a PICC line) because you may need long term or continuous therapy involving:

  • IV medication (antibiotics, chemotherapy, etc.)
  • IV nutrition
  • blood transfusions
  • frequent blood samples

What Are the Benefits of a PICC Line?

  • Eliminates frequent IV changes that can be painful.
  • Some medications can be irritating to the small veins in the lower part of your arm.
  • You can go home with a PICC line in place and receive medications at home.
  • This type of IV can stay in place for weeks to months depending on your needs or your course of treatment.

How is the PICC Line Inserted?

You will be taken to the Interventional Radiology department for the placement of this catheter. Once there, you will be placed on a table and a doctor or physician assistant will use an ultrasound machine to locate the veins in your arm. Once the vein is located they will numb the area of skin where the PICC will be inserted with a medication called Lidocaine. After the area is numb they will begin to place the catheter. The catheter will be threaded through the vein until the tip of the catheter lies in the large vein just above your heart. You should not feel the catheter as it threads up your arm. You may feel slight pressure during the insertion, this is normal. The catheter will be mostly under the skin with one or two “tails” that extend and hang out at the insertion site.

Caring for Your PICC Line

Once you are home, caring for your line is very important. Download a printable version of these home care instructions.

Key points

  • Be sure you have a safe and clean area to store your supplies.
  • Store the equipment on a table or shelf at or above waist height.
  • Develop a routine for line care so that your supplies are convenient.
  • Always wash your hands thoroughly before touching the line. You can wash your hands at the sink, or use sanitizing gel. Be sure to clean thoroughly and for the recommended amount of time.

Homecare Videos

If you have a PICC line in place, watch this two-part video to learn how to care for your line. Easy to follow, step-by-step instructions are provided to increase your confidence, reduce the risk of complications, and let you know when to contact your doctor.

Supplies for Changing Your Dressing

Be sure you have everything you will need for the dressing change.

  • Antiseptic swab or pad
  • Clean gloves
  • Drape
  • Two masks
  • Sterile gloves
  • Window dressing (gauze and tape)
  • You may be given an additional type of dressing that includes an antiseptic disk, which is placed around your catheter.

Removing the Old Dressing

  • Wash and dry your hands thoroughly.
  • Put on clean gloves.
  • Open the dressing kit and carefully remove the mask without touching anything else in the kit.
  • Put on the mask. If someone is assisting you, they will need to wear a mask as well.
  • Carefully remove the old dressing. Start by gently removing the tape around the edges first, working inward. Do not touch the skin around the insertion site. Be careful not to tug on the catheter.
  • Inspect the area around the site. Do not touch the site with your fingers. Check for redness, tenderness, swelling or drainage. If any of these are present, call your nurse and follow any additional instructions.
  • Remove your gloves and dispose of the old dressing and the gloves.

Applying the New Dressing

  • Open the sterile glove kit.
  • Put on the sterile gloves.
    – Without touching the outside of the sterile glove, carefully insert one hand into a glove; pull it on using the rolled back cuff.
    – Insert the other hand, and, without touching your skin, pull the glove on snugly.
  • Gently scrub the site with the antiseptic swab or pad beginning at the insertion site and working outwards in a circular pattern. Extend the cleaned area to a 3 x 3 inch area. Do not go back over any area that has already been cleaned. Wait until the skin is dry.
  • Apply skin protectant around the edges where the dressing will stick to your skin. Do not put protectant on or near the insertion site. Let the area dry.

Changing the Catheter Cap

  • Gather your supplies and assemble them in a clean work area: – alcohol pad – new cap – sterile gloves – two masks
  • Wash and dry your hands thoroughly.
  • Put on your mask. If someone is assisting, they will need to wear a mask as well.
  • Put on sterile gloves (see instructions under “Applying New Dressing”).
  • Open the end cap package and set aside, using the bottom of the package as a tray – be careful to keep the cap in its package.
  • Wipe the junction of the cap and line with an alcohol pad.
  • Remove the old cap and set aside.
  • Keep the line facing towards the ceiling at all times – this prevents the possibility of contamination. Never touch the connector or the inside of the cap.
  • Connect the new end cap securely.
  • Remove the gloves and throw the old cap and gloves away.
  • Immediately secure the tubing (see instructions below).

Securing the Tubing

  • Make a small loop in the tubing and position the ends to face upwards. Tape it onto the outside margins of the dressing itsel (so there is less tape on your skin). This will secure the tubing to
  • help prevent excess tension on the tube and reduce the risk of dislodgement.
  • Wash your hands.
  • Write the date on new dressing.

Flushing Your PICC Line

  • Flushing the line is important to prevent blood from clotting and blocking the catheter.
  • Gather your supplies and assemble them in a clean work area: – alcohol pad – 10 cc syringe prefilled with a solution – clean gloves
  • Wash and dry your hands thoroughly.
  • Put on clean gloves.
  • Make sure the tubing is clamped.
  • Thoroughly cleanse the catheter cap with an alcohol wipe and hold onto it to prevent contamination.
  • Inspect the syringe. Remove the cap. Hold the syringe facing upward and remove the cap with gentle pressure. If there are bubbles, flick the syringe with your finger to remove as many as possible. (A few small bubbles may remain, there is no danger.)
  • Insert the tip of the syringe into the center of injection cap.
  •  Unclamp the catheter.
  • Gently pull back on the syringe until you see a flash of blood. (This insures that there is no air in the line.)
  • Slowly push the plunger of the syringe to inject the solution.
  • Reclamp the catheter when your syringe only has about 1 ml left in it.
  • Immediately remove the syringe and dispose of it properly.
  • Never use the same syringe a second time.
  • Retape the tubing if necessary.
  • Wash your hands.
  • Note: You should not feel any resistance as you inject the solution. If you do, do not force it. Discontinue the procedure and call your home care nurse promptly.

General Precautions

Follow these general guidelines to prevent infection and stay safe.

  • Check your dressing daily, keep it clean, dry and in place.
  • The catheter will be mostly under the skin, there may be one or more “tails” that are exposed and extend out of the insertion site. Do not let catheter tails dangle freely, secure them to your arm.
  • Make sure an end cap is always attached to the end of the port.
  • Change the end caps with every dressing change.
  • Make sure the line clamped (closed) when not in use.
  • Wash your hands before and after any contact or handling the PICC line.
  • Use plastic wrap to cover the line during a shower or bath.
  • Change the dressing as often as directed by your healthcare provider.
  • Change the dressing as soon as possible if it becomes soiled or wet.
  • Never use pins or scissors near your PICC line.

What if the Catheter Gets Pulled?

  • Don’t panic. Check to see if the catheter is totally out or just a small length was pulled out. The catheter extends several inches inside the vein.
  • If the catheter is still in the skin, tape it in place. Put a bandage on the site and apply pressure for 10 minutes.
  • If the catheter has totally come out, apply pressure on the site for 10 minutes.
  • Either way, contact your doctor right away. If you feel it is an emergency, go to your nearest emergency room.

Common Reasons to Call Your Doctor or Nurse Promptly

  • Inability to flush using normal pressure
  • Pain, redness, or unusual drainage over or around the site
  • Fever of 100.4ºF or more
  • Ache, pain, or swelling in the shoulder, neck, arm or line site
  • Burning upon infusion of the medication
  • Any unusual bleeding
  • Inability to draw back blood from the catheter
  • You hear rushing water sounds in your ear
  • You feel vibration, movement, or pain in your jaw
  • You have facial flushing or enlarged neck veins
  • The catheter breaks
  • You have any chest pain or shortness of breath
  • Your skin is colder or a different color in the hand or arm of the PICC line
  • You have swelling in the hand or arm of the PICC line

How long will I have to have this line in place?

Only your physician can let you know how long your therapy will last. When you no longer need the therapy, the line can be removed.

Where will I get my supplies and equipment?

Your supply needs will be coordinated by a home care agency and you will receive instructions on their use. Store all your supplies in a clean, dry area, at waist height or above.

If You Have Any Questions or Concerns

Your PICC line is an important part of your care and we encourage you to call us if you have questions or concerns. Your physician can be reached by calling your clinic. After hours, on holidays or on weekends, call (716) 845- 2300 and ask to speak to the physician on call for your clinic. What to Do in an Emergency If you require medical attention outside of business hours, please go to the Buffalo General Hospital Emergency Room. The doctors and nurses at Buffalo General have access to your medical records and will work with Roswell Park to coordinate your care. If you live outside of the Buffalo area, please go directly to your nearest hospital emergency room.