Content

• Steps
• Part 1 of 2: Removing the catheter
• Part 2 of 2: Speeding up the recovery process
• Tips

A peripherally inserted central venous catheter (PICC) is a type of catheter that is usually inserted into the forearm. As the patient is treated, the attending physician will determine when the catheter should be removed. PICC catheter removal is a quick procedure that can only be performed by a qualified doctor or nurse.

Steps

Part 1 of 2: Removing the catheter

1. 1 Remember, only trained nurses and doctors can remove the PICC catheter. Be aware that only doctors or nurses who have been specially trained in patient care can remove a peripherally inserted central venous catheter (PICC). Otherwise, serious complications or infection can occur.
   • Therefore, you should only follow these instructions if you are a doctor or nurse. Patients should use this article for informational purposes only.
2. 2 Wash your hands. Before proceeding with the procedure or touching any materials required to remove the PICC catheter, wash your hands thoroughly with antibacterial soap and put on a new pair of sterile gloves.This reduces the patient's chances of getting an infection.
3. 3 Get everything you need to remove the catheter. Before removing the PICC catheter, prepare all materials to be used throughout the procedure so that they are at your fingertips.
   • These materials include: a pair of sterile scissors, a breathable dressing, a scalpel to remove stitches, a sterile dressing, and cotton swabs dipped in iodine.
   • Place all of these materials in order near the patient's bedside before the procedure for easy retrieval.
4. 4 Explain to the patient the procedure for removing the PICC catheter. Explain the process of removing the PICC catheter to the patient in order to establish a relationship of trust and cooperation with the patient. Be prepared to answer any questions the patient might ask you about the procedure.
5. 5 Place the patient in the desired position. Before starting the procedure, ask the patient to take the correct position. He should lie flat on his back, face up, arms and legs should be on the bed. This is called the recumbent position.
   • Make sure the patient has a clean bed with fresh sheets. This will make the patient more comfortable and reduce the risk of infection.
6. 6 Treat the skin around the catheter. Take a cotton swab soaked in iodine and swab the area around the PICC catheter. Work the skin away from the catheter towards the farther areas of the skin.
   • This is a very important step as you will remove any bacteria from the surface of your skin, thereby reducing the chances of infection.
   • After you have treated your skin, unplug the infusion set and prepare a dressing so that you can apply a dressing immediately after the procedure.
7. 7 Remove the catheter. Using a suture scalpel, carefully cut and remove the thread holding the PICC catheter. Ask the patient to hold their breath, then, using your dominant hand, slowly pull the catheter in the opposite direction of insertion. Do not apply direct pressure to the site of the catheter.
   • After removing the catheter, immediately cover the insertion site with sterile gauze and hold it in place with light pressure.
   • Ask the patient to hold their breath while you bandage the wound with an airtight bandage. Once this is done, allow the patient to breathe normally and return to a comfortable position.
8. 8 Observe the patient's condition for the next 24-48 hours. After removing the PICC catheter, monitor the patient for 24-48 hours. Watch for any signs of infection, such as fever. In addition, watch for bleeding and also observe if the patient has any breathing problems.
   • The dressing should not be removed for 24-72 hours, depending on how long the patient has had the catheter.

Part 2 of 2: Speeding up the recovery process

1. 1 Inform the patient about the complications that may arise after removing the PICC catheter. Some complications may arise after removing the PICC catheter. It is very important that the patient is aware of these complications before having the catheter removal procedure. Possible complications:
   • Broken PICC catheter. This is the most common complication of PICC catheter removal. To prevent breakage, the catheter must be removed gently without using too much force.
   • Infection. This is another complication that a patient with a PICC catheter can experience. The infection can occur at any time. Therefore, it is useful to regularly check the PICC catheter and maintain its sterility as closely as possible.
   • Embolism and catheter breakage. These are potentially serious complications that can occur after the PICC catheter is removed. They can lead the patient to unconsciousness if the blood clot reaches the brain.
   • Swelling and redness. These symptoms can also occur as a complication after the removal of the PICC catheter. Swelling and redness usually appear in the area where the catheter was inserted.
2. 2 Advise the patient on the correct dosage of pain medications. After removal of the catheter, the patient may experience shoulder pain. Because of this, the attending physician may prescribe pain relievers or recommend over-the-counter medications so that the patient can safely go about their daily activities.
   • Ibuprofen is one of the most common over-the-counter pain relievers that is recommended after the PICC is removed. Ibuprofen is a non-steroidal anti-inflammatory drug that has antipyretic and analgesic properties.
   • The recommended dose of ibuprofen (according to the Centers for Disease Control and Prevention) is 200-400g taken orally every 4-6 hours. It is also recommended to take ibuprofen with food or milk to avoid stomach problems.
3. 3 Inform the patient about what physical activity should be avoided. Be sure to inform the patient to avoid any strenuous physical activity or hard work for at least 24 hours after removing the PICC catheter. For example, do not move furniture, lift heavy boxes, or engage in any activity that involves repetitive arm or hand movements.
4. 4 Tell the patient about proper nutrition. Eating a healthy diet plays an important role in the recovery process, so it is worth telling the patient what food to eat during treatment.
   • He must consume a lot of iron-rich foods in order to improve blood circulation and strengthen the body. These include red meat, chicken, spinach, broccoli, shellfish, pumpkin and sesame seeds, as well as nuts such as peanuts, pecans, pistachios and almonds.
   • If the patient has lost weight, then it is better for him to eat high-calorie smoothies and shakes, rich in nutrients, vitamins and natural sugars, which will help the patient to gain weight in a healthy way.
   • You should advise the patient to eat not three times a day in large portions, but to eat more often, but in small portions during the day. Thanks to this, the body's energy reserve will always be at the level.

Tips

• If an infection is suspected, get an appointment from your doctor for the tip of the catheter to be sent to the laboratory for culture. This test will confirm the presence of infection in the PICC catheter.