BASIC STEPS FOR A PICC PULL:
Introduce yourself & HHC. Wash/Sanitize hands.
Confirm that we have an order to pull the line. It should not be assumed that the line is to be pulled simply because therapy has ended. You MUST have an order!
Gather all neccessary supplies. Please note that in the home setting suture removal kits are not provided. If the line has sutures still in place, please use alcohol swabs to clean scissors and snip the sutures. A small pair of scissors is provided in your car kit.
Clean the skin around the catheter with the provided cleansing agent (open a dressing change kit for agent), moving from the skin nearest the catheter outwards. **Have your pressure dressing ready to apply
Use scissors to carefully cut and remove any sutures that hold the PICC line in place
Ask patient to hold his or her breath, then using your dominant hand, slowly pull the catheter out.**Do not apply any direct pressure on the insertion site. Never force the line out. If you meet resistance, STOP and wait. Try again. You may need to apply a warm compress to the site to encourage vein dilation. If after troubleshooting, the line will not come out. Reach out to the Agency immediately, for next steps.
Once removed, immediately cover the insertion site with sterile gauze and hold it in place with light pressure. Have the patient continue holding breath while you cover the area with dressing (gauze and tape)
Use the tape measure inside the dressing change kit to measure the length of the catheter.
Assess for any signs of infection or difficulty breathing
Advise Pt to leave dressing for 24-48 hours and to avoid engaging in any strenuous exercises or doing any heavy lifting with the limb that contained the line for a minimum of 24 hours.
Document the procedure, how the Pt tolerated it, the length of the removed line, and if the tip appears intact.