PICC Line Removal | How to Remove a PICC Line | Clinical Nursing Skills

Nurses must make sure that a PICC line remains functioning properly and that the dressing around it remains sterile.  PICC lines are catheters that help patients maintain their good health.  At some point, patients must have their PICC lines removed so that they can continue to maintain their good health. Nurses must be prepared to remove PICC lines in the safest manner possible. This is an important nursing skill that be performed on a frequent basis for most nurses.

What Is A PICC Line?

A peripherally inserted central catheter or PICC line is small, long, flexible, slender tube that nurses insert into a patient’s peripheral vein.  The insertion usually is in the upper arm area.  The PICC line usually advances until the tip of the catheter ends in a large vein in the patient’s chest near their heart to gain access intravenously.

Steps on PICC Line Removal

When patients no longer need their peripherally inserted central catheter, it must be removed.  Registered nurses qualified to give intravenous medication are the only nurses who can remove PICC lines. This painless procedure takes a few minutes to complete by a trained nurse.

1. Gather the necessary materials to remove the PICC line.  The materials include sterile scissors, sterile dressing packages, stitch cutter, air occlusive dressing, hibitane solution, and sterile gloves.
2. Wash the hands thoroughly and put on a new pair of sterile gloves before proceeding.
3. Take a few moments to explain the PICC line removal process to the patient.  Answer any questions that he or she may have about the procedure.
4. Organize the materials near the patient’s bedside before performing the procedure.  Turn off the infusions and prepare the dressing patch before positioning the patient.
5. Place the patient in the supine or Trendelenburg position to remove the PICC line.
6. Using the stitch cutter, carefully remove the suture that holds the central venous catheter.  Hold the suture in a manner that ensures that it does not migrate accidentally.
7. Prepare the patient for the next step by asking him or her to hold the breath as the nurse removes the catheter. Cover the area immediately with sterile gauze and hold the gauze in place with a light amount of pressure.
8. While the patient is still holding his or her breathe, cover the area with an occlusive dressing.  Reposition the patient once the process is complete. Tell the patient that it is okay to stop holding his or her breathe.
9. It is necessary to document aspects of the procedure.  Use the progress notes to document the date, time, type, and condition of the catheter at the time the central line was removed. Also, make notes on the condition of the patient.  Chart conditions such as discharge, swelling, and redness of the patient’s skin.
10. The nurse should monitor the patient for the next 24-48 hours following the procedure. The dressing should remain in place for 24-72 hours, according to the timeframe in which the catheter was in position.   Closely watch the patient after the removal for signs of infection, bleeding, and air embolism.

Tips for Removing a PICC Line

• Make sure that the hands are clean before handling the PICC line removal items and supplies.
• A PICC line should be covered with clean, secure dressing at all times to prevent infection and migrant infection.
• A PICC line can only be removed at the order of a doctor.
• Use slow, intermittent traction when removing a PICC line.  Do not apply direct pressure to the insertion site.
• Send the tip of the catheter to the lab for a culture if infection is suspected.  Make sure to get a doctor’s order before sending to the lab.

Complications Encountered During PICC Line Removal

One of the most common complications encountered during PICC line removal is breakage during removal. It is important not to remove the PICC line with force. Infection is another complication that patients encounter. Infections can exist at any time so it is important to monitor the PICC line and maintain sterile techniques as much as possible. Another complication is an embolism or catheter fracture that can result in a change in consciousness in the patient. Patients may also experience a temporary swelling or redness (Phlebitis) near the catheter site.

Only registered nurses have the qualifications to care for or remove a PICC line from a patient’s body. Nurses must take care when removing a patient’s PICC line to ensure that the patient has a painless experience. Monitoring the patient after the PICC line removal is very important to the recovery of the patient.