PICC Removal

A peripherally inserted central catheter (PICC) is a form of IV access that allows medicines and IV fluids to be quickly distributed throughout the body. The PICC is a thin, flexible tube (catheter) that is inserted into a vein in your arm or leg.

The PICC is guided through your vein until the tip sits in a large vein just outside your heart (superior vena cava or SVC). A PICC may be removed if it is no longer needed, if it causes infection, or if it is not working properly.

This is usually a painless procedure. Only a trained health care provider should do this procedure. Do not try to remove a PICC line yourself.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Infection.
• Vein blockage due to an air bubble (air embolism).

What happens before the procedure?

• A conversation with your health care team. You need an order from your health care provider to have the PICC removed.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
  • Hair may be removed from the surgical area.
• You will lie down flat. Your head may be positioned slightly lower than your heart. You may be instructed to keep as still as possible during the procedure.
• The bandage (dressing) over the PICC will be removed.
• The place where the PICC tube exits the body (exit site) will be cleaned with a germ-killing (antiseptic) solution.
• A germ-free (sterile) gauze pad will be held gently over the exit site.
• The health care provider will pull out the PICC tube slowly and steadily. You may be asked to hold your breath or exhale while this is done.
• After the PICC tube is removed, the health care provider will gently press on the exit site for about five minutes.
• Antibiotic or petroleum-based ointment will be applied to the exit site.
• The exit site will be covered with an airtight (occlusive) sterile dressing, or another type of dressing.
• The PICC will be inspected to make sure that the entire tube has been removed. Part of the PICC may be tested for bacteria.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You may need to stay lying down.
• You will be monitored to make sure that:
  • There is no fluid draining from the exit site.
  • There are no signs of an air embolism.

Summary

• A PICC may be removed if it is no longer needed, if it causes infection, or if it is not working properly.
• Only a trained health care provider should do this procedure. Do not try to remove a PICC line yourself.
• Generally, this is a safe procedure. However, problems may occur, including bleeding, infection, or air embolism.
• Plan to have someone with you for 24 hours after the procedure.
• After the procedure, you will be monitored to make sure that there is no fluid draining from the site and that there are no signs of an air embolism.

PICC Removal, Adult, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After your procedure, it is common to have:

• Tenderness or soreness.
• Redness, swelling, or a scab where the PICC was removed (exit site).

Follow these instructions at home:

For the first 24 hours after the procedure

• Keep the bandage (dressing) on the exit site clean and dry. Do not remove the dressing until your health care provider tells you to do so.
• Check your arm often for signs and symptoms of an infection. Check for:
  • A red streak that spreads away from the dressing.
  • Blood or fluid that you can see on the dressing.
  • More redness or swelling.
• Do not lift anything heavy or do activities that require great effort until your health care provider says it is okay. You should avoid:
  • Lifting weights.
  • Yard work.
  • Any physical activity with repetitive arm movement.
• Watch closely for any signs of an air bubble in the vein (air embolism). This is a rare but serious complication. If you have signs of air embolism, call 911 immediately and lie down on your left side to keep the air from moving into the lungs. Signs of an air embolism include:
  • Difficulty breathing.
  • Chest pain.
  • Coughing or wheezing.
  • Skin that is pale, blue, cold, or clammy.
  • Rapid pulse.
  • Rapid breathing.
  • Fainting.

After 24 Hours have passed:

• Remove your dressing as told by your health care provider. Make sure you wash your hands with soap and water before and after you change the dressing. If soap and water are not available, use hand sanitizer.
• Return to your normal activities as told by your health care provider.
• A small scab may develop over the exit site. Do not pick at the scab.
• When bathing or showering, gently wash the exit site with soap and water. Pat it dry.
• Watch for signs of infection, such as:
  • Fever or chills.
  • Swollen glands under the arm.
  • More redness, swelling, or soreness in the arm.
  • Blood, fluid, or pus coming from the exit site.
  • Warmth or a bad smell at the exit site.
  • A red streak spreading away from the exit site.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider. Do not take any new medicines without checking with your health care provider first.
• If you were prescribed an antibiotic medicine, apply or take it as told by your health care provider. Do not stop using the antibiotic even if your condition improves.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever or chills.
• You have soreness, redness, or swelling on your exit site, and it gets worse.
• You have swollen glands under your arm.
• You have any of the following symptoms at your exit site:
  • Blood, fluid, or pus.
  • Unusual warmth.
  • A bad smell.
  • A red streak spreading away from the exit site.

Get help right away if:

• You have numbness or tingling in your fingers, hand, or arm.
• Your arm looks blue and feels cold.
• You have signs of an air embolism, such as:
  • Difficulty breathing.
  • Chest pain.
  • Coughing or wheezing.
  • Skin that is pale, blue, cold, or clammy.
  • Rapid pulse.
  • Rapid breathing.
  • Fainting.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• After your procedure, it is common to have tenderness or soreness, redness, swelling, or a scab at the exit site.
• Keep the dressing over the exit site clean and dry. Do not remove the dressing until your health care provider tells you to do so.
• Do not lift anything heavy or do activities that require great effort until your health care provider says it is okay.
• Watch closely for any signs of an air embolism. If you have signs of air embolism, call 911 immediately and lie down on your left side.