Picc and Hohn Catheter Line Care
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The dressing should be changed at least 2-3 times/week If the dressing becomes wet, soiled or loose, it should be changed more frequently.
How to change a dressing
- Wash hands thoroughly
- Put on examination gloves and a face mask
- Remove the old dressing, making sure not to remove the catheter
- Inspect catheter for kinks, cracks, or leaks. Confirm sutures remain intact. Examine skin for redness, swelling, induration, or drainage.
- Remove the examination gloves
- Open packages of sterile gloves, sterile gauze, Tegaderm, and betadine swabs. Put on sterile gloves
- Clean site with betadine and allow to air dry. Then remove betadine using alcohol swabs
- Place a sterile 2x2 inch gauze on catheter exit site
- Apply Tegaderm to site
- Confirm the catheter is not kinked by dressing and that the arm has good mobility with the new dressing
- Catheter must be capped when not in use. Make certain caps are tight and that there are no cracks in the catheter or cap. If there is a crack, notify Angiography/Interventional Radiology immediately
- If line also has a clamp on the catheter this should also be closed whenever line is not in use
- The catheter should be taped to the skin so it is not going to be pulled on or damaged
- Each lumen should be flushed at least once a day. Flush is 10cc of normal saline followed by 2 cc of heparin flush (100 units heparin per cc of normal saline).
- Each lumen should be flushed with 10cc normal saline before use.
- After use the catheter should be flushed with normal saline and heparin flush as described above
- If the catheter is on continuous infusion it still should have flushing with normal saline and heparin at least once per day
- The line can be used for blood draws. A 5 cc discard should first be removed from the line. Flushing with normal saline and heparin as described above should be done after each blood draw
- The catheter must be capped whenever it is not in use. If catheter also has a clamp it should be used as well.
- If catheter is partially pulled out, do not attempt to reinsert it. If catheter falls out completely, apply gentle pressure to the entry site for 10 minutes.
- If catheter appears damaged or is leaking, it must not be used. Place a clamp near the skin entry site and call angiography/Interventional Radiology
- Fevers, or changes at the catheter entry site such as redness, swelling, drainage, or tenderness should be reported to a physician.
- Call Angiography/Interventional Radiology if catheter will not allow aspiration of blood.
- Call Angiography/Interventional Radiology if arm or neck swelling develop.
- Call Angiography/Interventional Radiology at 924-9401 with any questions or problems. After hours call the radiology department at 924-9400 and ask to speak to the Angiography/Interventional fellow on call.
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