PICC Line Management 🙋
Guide for PICC line management. Care, troubleshooting, complications, and maintenance of peripherally inserted central catheters.
Overview
- PICC lines are inserted into upper arm veins (cephalic, brachial or basilic), and terminate in the superior vena cava.
Indications for PICCs
- Inadequate peripheral venous access
- Administration of noxious medications (e.g. chemotherapy, TPN, vasopressors)
- Long duration of IV therapy (e.g. prolonged antibiotic therapy)
- Long term vascular access for blood sampling
Taking Bloods from a PICC
- Prepare a sterile tray with gloves, two empty 20ml syringes, a 10ml saline syringe, and an alcohol swab.
- Don gloves, disinfect the access port, and unclamp the line.
- Aspirate 20ml with the first syringe (discard), then collect 20ml for labs with the second.
- Flush with saline and reclamp. Transfer blood to bottles using caution.
Removing a PICC Line
- Gather sterile gauze and scissors.
- Detach the top of the securement device by lifting tabs and unclipping.
- Place gauze at the site, withdraw the line slowly, and apply pressure.
- Cut and remove the lower part of the securement device per instructions.
- Refer to local guidelines or training materials if unsure of removal technique.
Unblocking a PICC Line
- Prescribe Hepsal (10 IU/ml, 5ml) 3–4 times daily. Flush after use and clamp the line.
- If blocked, instill 2ml Alteplase (1mg/ml), let dwell 20 minutes.
- Aspirate 10ml, flush with saline before use.
- Alteplase is typically stored in the fridge on haematology/specialty wards.