Fundamentals
The acronym PICC stands for
Peripherally Inserted Central Catheter
The technique used in flushing a PICC
Pulsatile/push-pause
First step in managing a PICC sluggish to flush
Flush with a strong pulsatile technique with 2x10ml saline
A drug used to unblock CVADs
Alteplase
Action to take when resistance is felt during PICC removal
Stop/Consult with medical staff
Inserted peripherally, the tip of the PICC is located here
Superior Vena Cava (Cavoatrial Junction)
Apart from when needed, this is how often the dressing and securement device needs to be changed
weekly or 7 days
A complication noted where there is swelling and pain in the arm
Thrombosis
two
Rationale for the PICC to protrude through the centre of the Biopatch disc
achieve 360 coverage; prevent infection from the insertion site
At the most, this is the recommended maximum dwell time a PICC can stay in
Up to 12 months
If the external length of the catheter changes by this much, PICC used must be ceased and tip position must be confirmed
2cm or more
Initial test when the PICC is suspected to be the source of infection
blood culture - PICC and peripheral
Recommended dwell time of the medication for unblocking to increase success
30-120 minutes
In suspicion of infection, this action is done after PICC removal
Send catheter tip for culture
These are the veins where PICCs are usually inserted into
Basilic and Brachial
A patient with a PICC wants to take a shower and asks if there is any precaution for them to take
Cover the dressing area with plastic wrap and tape; avoid the PICC to be wet at all
Prep used if patient is allergic to chlorhexidine
iodine 0.5% (Betadine) in alcohol 70%
Risk/s associated when using excessive pressure during medication instillation
Rupture or embolism
2 minutes
Rationale for avoiding syringes less than the recommended volume
risk of catheter rupture due to high pressure
Rationale why a TKVO is not acceptable in maintaining PICC patency
low flow/pressure does not maintain patency
Power injectable PICCs with a universal color of Purple are able to take 300 PSI and are compatible with what injector
CT power injector
Patient with a confirmed CVAD infection and blocked PICC. Use alteplase or not? Why?
No, due to risk of systemic infection spread
PICCs inserted from another hospital need these two actions done prior to use
CXR/confirmation of placement prior to use; dressing changed within 24 hours of admission