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Peripherally inserted central catheter - dressing change

PICC - dressing change

What to expect at home

You have a peripherally inserted central catheter (PICC). This is a tube that goes into a vein in your arm. It carries nutrients and medicines into your body. It is also used to draw blood when you need to have blood tests.

Dressing changes

A dressing is a special bandage that blocks germs and keeps your catheter site dry and clean.You should change the dressing about once a week. You need to change it sooner if it becomes loose or gets wet or dirty.

Since a PICC is placed in one of your arms and you need two hands to change the dressing, it is best to have someone help you with the dressing change. Your nurse will teach you how your dressing should be changed. Have the person who helps you also watch and listen to the nurse's instructions.

Your doctor has given you a prescription for the supplies you need. You can buy these items at a medical supply store. It helps to know the name of your catheter and what company makes it. Write this information down and keep it handy.

Changing your dressings

The information below outlines the steps for changing your dressing. Follow any additional instructions your doctor or nurse gives you.

To change the dressing, you need:

  • Sterile gloves
  • A face mask
  • Cleaning solution (such as chlorhexidine) in a single-use small applicator
  • Special sponges or wipes that contain a cleaning agent, such as chlorhexidine
  • A special patch called a Biopatch
  • A clear barrier bandage, either Tegaderm or Covaderm
  • 3 pieces of 1-inch wide tape, 4 inches long (with one of the pieces torn in half, lengthwise)

If you have been prescribed a dressing change kit, follow the instructions for using the supplies in your kit.

Prepare to change your dressing in a sterile (very clean) way.

  • Wash your hands for 30 seconds with soap and water. Be sure to wash between your fingers and under your nails.
  • Dry your hands with a clean paper towel.
  • Set up the supplies on a clean surface, on a new paper towel.

Remove the dressing and check your skin.

  • Put on the face mask and a pair of sterile gloves.
  • Gently peel off the old dressing and Biopatch. Do not pull or touch the catheter where it comes out of your arm.
  • Throw away the old dressing and gloves.
  • Wash your hands and put on a new pair of sterile gloves.
  • Check your skin for redness, swelling, bleeding, or any other drainage around the catheter.

Clean the area and catheter.

  • Use one special wipe to clean the catheter.
  • Use the other wipe to clean the catheter, slowly working away from where it comes out of your arm.
  • Clean your skin around the site with the sponge and cleaning solution for 30 seconds.
  • Let the area air dry.

To place a new dressing:

  • Place the new Biopatch over the area where the catheter enters the skin. Keep the grid side up and the white side touching the skin.
  • If you have been told to do so, apply a skin prep where the edges of the dressing will be.
  • Coil the catheter. (This is not possible with all catheters.)
  • Peel the backing from the clear plastic bandage (Tegaderm or Covaderm) and place the bandage over the catheter.

Tape the catheter to secure it:

  • Place 1 piece of the 1-inch tape over the catheter at the edge of the clear plastic bandage.
  • Place another piece of the tape around the catheter in a butterfly pattern.
  • Place the third piece of tape over the butterfly pattern.

Throw away the face mask and gloves and wash your hands when done. Write down the date you changed your dressing.

Other care

Keep all the clamps on your catheter closed at all times. If instructed, change the caps (ports) at the end of the catheter when you change your dressing and after blood draws.

It is OK to take showers and baths 7 to 10 days after your catheter is put in place. When you do, make sure the dressing is secure and your catheter site stays dry. Do not let the catheter site go under water if you are soaking in a bathtub.

When to call the doctor

Call your doctor or nurse if you have:

  • Bleeding, redness, or swelling at the site
  • Dizziness
  • Fever or chills
  • Hard time breathing
  • Leaking from the catheter, or the catheter is cut or cracked
  • Pain or swelling near the catheter site, or in your neck, face, chest, or arm
  • Trouble flushing your catheter or changing your dressing

Also call your doctor if your catheter:

  • Is coming out of your vein
  • Seems blocked

References

Best Practices: Evidenced-based Nursing Procedures. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007:chap 4: Intravascular therapy.

Infusion Nurses Society. Infusion Nursing: Standards of Practice; Revised 2011. J Infus Nurs. 2011;34(1S):S37-S48.

Update Date: 2/7/2014

Updated by: John A. Daller, MD, PhD., Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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