How to Remove a PICC Line

Does the idea of removing a PICC line make you feel uneasy?

You’re not alone. Many health care professionals feel anxious about this procedure because they may worry about potential complications that could cause discomfort or harm.

But having the right knowledge and skills can increase competency to safely remove a PICC line. This guide will walk you through the process step-by-step so you can provide the best care for clients.

Steps on PICC Line Removal

Peripherally inserted central catheters (PICC) are vital in efficiently delivering medications, nutrients, and fluids to clients.

However, when the time comes for removal, nurses need to implement the proper procedure to ensure a smooth and safe process.

Follow these steps to remove a PICC line safely:

1. Prepare. Gather all necessary supplies, including hibitane solution, sterile dressing, sterile gloves, sterile scissors, and a stitch cutter. Explain the procedure to the client to ease anxiety and obtain informed consent.

2. Maintain a sterile environment. Wash hands thoroughly and put on sterile gloves. Clean the PICC line insertion site with an antiseptic solution. Place a sterile drape around the area.

3. Position the client. Ensure the client is comfortable, lying flat on their back with the arm extended and secured to prevent sudden movements during removal.

4. Get assistance. While a single nurse can remove a PICC line, having a colleague assist with holding supplies or supporting the client can streamline the process.

5. Remove sutures. If sutures hold the PICC line in place, carefully cut and remove them using sterile scissors. Gently pull the line to loosen it from the vein.

6. Assess the exit site. Inspect the exit site for signs of discharge, infection, redness, or swelling. If you see abnormalities, consult the health care provider (HCP) before proceeding.

7. Remove the PICC line. Have the client take a deep breath and hold it. While the client holds their breath, gently and steadily pull the PICC line out. Dispose of the PICC line in a sharps disposal container. The client should lie flat for about 30 minutes after the line is pulled.

8. Apply pressure and dressing. To control bleeding, apply pressure to the exit site with a sterile gauze pad. Secure the site with a sterile dressing. Document the removal procedure in the client’s chart.

9. Monitor. Observe the client for the next 24 to 48 hours for any signs or symptoms of infection at the removal site.

How Painful is PICC Line Removal?

The level of discomfort experienced during PICC line removal can vary from client to client.

While some individuals may report minimal pain, like a brief pinch or tug, others might feel a slight burning sensation when the nurse extracts the line. The insertion site may be tender or slightly sore afterwards, which is normal.

Proper technique and client preparation can minimize discomfort. Communicate with the client throughout the process, addressing any concerns and providing reassurance to reduce anxiety and pain.

Potential Risks

Despite being a routine procedure, PICC line removal carries certain risks that nurses should be aware of:

• Air embolism: If air enters the bloodstream during removal, it can cause a potentially life-threatening condition. Signs to look for in the client are chest pain, headache, difficulty breathing and confusion. To avoid this, ensure the patient is upright and instructed to hold their breath during the extraction process.

• Bleeding: Some bleeding may occur at the exit site. Apply pressure to control it.

• Catheter fragmentation: Always inspect the catheter after removal to ensure it’s intact. In rare cases, the catheter may break and leave a portion inside the vein, which can lead to serious complications. If this happens, seek immediate medical attention.

• Infection: Improper technique during removal can lead to infection at the exit site. Monitor for symptoms and signs of infection, such as redness, swelling, warmth, or drainage.

• Phlebitis: Vein inflammation may occur after removing the PICC line, causing pain and discomfort. Applying warm compresses can help alleviate symptoms.

Helpful Tips for PICC Line Removal

Here are five tips to make the PICC line removal process as smooth and comfortable as possible for clients:

1. Explain the procedure. Inform the client about what to expect during PICC line removal, including any potential discomfort. This can help alleviate anxiety and prepare them for the procedure.

2. Assess the client’s pain level before starting the removal process. This can help determine if the client needs any analgesics.

3. Use distraction techniques. Encourage the client to engage in deep breathing, listen to music, or talk to a support person during removal. This can help distract them from any anxiety or discomfort.

4. Stay calm. Remain calm and reassuring during the procedure. This can also help the client feel more at ease. If you encounter resistance or complications, remain calm, stop the procedure, and reassess the situation. Seek help from a colleague or supervisor if needed.

5. Follow up. Schedule a follow-up appointment with the client’s HCP to monitor for complications and ensure proper healing.

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