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 will help carry nutrients and medicines into your body. It will also be used to take blood when you need to have blood tests.
Dressings are special bandages that block germs and keep your catheter site dry and clean. You will learn how to change your dressings. You should change the dressing about once a week. You will need to change it sooner if it becomes loose or gets wet or dirty.
After some practice, it will get easier. A friend, family member, caregiver, nurse, or your doctor may be able to help you.
Your doctor will give you a prescription for the supplies you will need. You can buy these at a medical supply store. It will help to know the name of your catheter and what company made it. Write this information down, and keep it handy.
Changing Your Dressings
To change your dressings, you will need:
A cleaning solution (such aschlorhexidine) in a single-use small applicator
2 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 (tear one of the pieces in half lengthwise)
You will change your dressings in a sterile (very clean) way. Follow these steps:
Wash your hands for 30 seconds with soap and water. Be sure to wash between your fingers and under your nails.
Dry with a clean paper towel.
Set up your supplies on a clean surface on a new paper towel.
Loosen the edge of the old dressing.
Put on a pair of clean gloves.
Follow these steps to remove the dressing and check your skin
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 then put on a pair of sterile gloves.
Check your skin for redness, swelling, or any bleeding or other drainage around the catheter.
You will then clean the area and catheter.
Use one special wipe to hold the catheter where it comes out of your arm. Then use the other wipe to clean the catheter, slowly working away from where it comes out of your arm.
Clean the skin around the site with the sponge and cleaning solution for 30 seconds.
Let air dry the area after you clean it.
You will then place a new dressing.
Place the new Biopatch over the area where the catheter enters your skin. Keep the grid side up and the white side touching your 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.
You will then tape the catheter to help 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.
Throw away the gloves and wash your hands when you are done. Write down the date you changed your dressing.
Keep all of the clamps on your catheter closed at all times. It is a good idea to change the caps at the end of your catheter (called the “claves”) when you change your dressing and after blood draws.
It is okay to take showers and baths 7 - 10 days after your catheter was put in place. When you do, make sure the dressings are 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
- Develop swelling in the arm downstream of where the catheter is
- Leaking from the catheter, or the catheter is cut or cracked
- Pain near the site, or in your neck, face, chest, or arm
- Fever or chills
- A hard time breathing
- Trouble flushing your catheter or changing your dressings
Also call your doctor if your catheter
- Is coming out of your vein
- Seems blocked
Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.