Bard Access Systems, Inc.

How to Care For Your

Patient Guide
Table of Contents

Page

Introduction

1.. What is a PowerPICC SOLO* Catheter............................... 1

2.. How Does the Valve Work?................................................... 2

3.. What is the PICC Used For?................................................. 3

4.. Where Does the PICC Go Inside the Body?......................... 3

5..
. What is Required to Take Care of the PICC?........................ 4
. a. Site Care ......................................................................... 5
. b. Clamping The PICC.......................................................... 8
. c. Flushing The PICC........................................................... 9
d. Changing The Injection Cap........................................... 11
. e. Be Able To Detect Problems And Know What To Do.............. 13
6.. Questions Other Patients Have Asked................................ 17

7.. Quiz/Answers................................................................. 24-25

8.. Catheter Information and Supply List.................................. 27

9.. Acknowledgement Card...................................................... 28

 PICC Catheter Hub

Extension Leg

Junction

Reverse Taper

www.bardaccess.com www.powerpiccsolo.com
 What is a PowerPICC SOLO*
1 Catheter?
PICC is a short name for “Peripherally Inserted Central Catheter”, reflecting
the fact that the catheter is inserted into a large vein in your arm (usually the
basilic or cephalic vein). Unlike most catheters, the PowerPICC SOLO*
catheter has a valve that allows liquids to flow in or out but it remains closed
when it is not in use. The PowerPICC SOLO* catheter may also be used
for contrast power injections at up to 5 ml/sec.

New Impor tant Information:

Recommended Flushing/Maintenance Procedure(s)

The catheter should be maintained in accordance with standard hospital proto-

cols. Recommended catheter flushing/maintenance is as follows:

1. Flush the catheter after every use, or at least weekly when not in use. Use a
10 ml or larger syringe.
2. Flush the catheter with a minimum of 10 ml of 0.9% sodium chloride, using a
“pulse” or “stop/start” technique. Use of heparinized saline to lock each
lumen of the catheter is optional.
3. Disconnect the syringe and attach a sterile end cap to the catheter hub and
tighten securely.
4. Prior to blood sampling when infusing Total parenteral nutrition (TPN), follow
routine maintenance procedure except use 20 ml saline and flush to clear
TPN from the catheter.
5. If resistance is met when flushing, no further attempts should be made.
Further flushing could result in catheter rupture with possible embolization.
Refer to institution protocol for clearing occluded catheters.

NOTE: When injecting or infusing medications that are incompatible, you

should always flush the catheter with a minimum of 10 ml saline before and
after each medication.

NOTE: When maintained in accordance with these instructions, the

PowerPICC SOLO* catheter does not require the use of heparinized saline to
lock the catheter lumens. However, use of heparinized saline will not adversely
effect the catheter and may be necessary based on patient status or use of
alternate flushing and locking techniques.

Caution: Always remove needles or needleless caps slowly while injecting the
last 0.5 ml of saline.

Caution: Use aseptic techniques whenever the catheter lumen is opened or

connected to other devices.

Caution: The PowerPICC SOLO* catheter is designed for use with a needle-
less injection caps or “direct-to-hub” connection technique. Apply a sterile end
cap on the catheter hub to prevent contamination when not in use. Use of a
needle longer than 1.6 cm (0.625 in.) may cause damage to the valve.

Warning: Alcohol should not be used to lock, soak or declot polyurethane

PICCs because alcohol is known to degrade polyurethane catheters over time
with repeated and prolonged exposure.
1
Power Injection Procedure
1. Remove the injection/needleless cap from the PowerPICC SOLO*
catheter.
2. Attach a 10 ml or larger syringe filled with sterile normal saline.
3. Aspirate for adequate blood return and vigorously flush the catheter
with the full 10 ml of sterile normal saline.
Warning: Failure to ensure patency of the catheter prior to power
injection studies may result in catheter failure.
4. Detach syringe.
5. Attach the power injection device to the PowerPICC SOLO* catheter
per manufacturer’s recommendations.
6. Contrast media should be warmed to body temperature prior to power
injection.
Warning: Failure to warm contrast media to body temperature prior to
power injection may result in catheter failure.
7. Use only lumens marked “Power Injectable” for power injection of
contrast media.
Warning: Use of lumens not marked “Power Injectable” for power
injection of contrast media may cause failure of the catheter.
8. Complete power injection study taking care not to exceed the flow rate
limits. Do not exceed the maximum flow rate of 5 ml/sec.
Warning: Exceeding the maximum flow rate of 5 ml/sec, or the
maximum pressure of power injectors of 300 psi, may result in catheter
failure and/or catheter tip displacement.
Warning: Power injector machine pressure limiting feature may not
prevent over-pressurization of an occluded catheter, which may cause
catheter failure.
9. Disconnect the power injection device.
10. Replace the injection/needleless cap on the PowerPICC SOLO*
catheter.
11. Flush the PowerPICC SOLO* catheter with 10 ml of sterile normal
saline, using a 10 ml or larger syringe. Use of heparinized saline to
lock each lumen of the catheter is optional.

How does the valve work?

2
The PowerPICC SOLO* catheter valve controls the flow of fluids to provide
clamp-free infusion therapy. Positive pressure into the catheter (gravity,
pump, syringe) will open the valve, allowing fluid infusion. When negative
pressure (aspiration) is applied, the valve opens allowing for the withdrawal
of blood into a syringe.
• Routine clamping of the catheter outside the body is not needed.
• Heparin is not needed to keep the catheter open.

2
 What is the PICC used for?
3
There are several uses for the PowerPICC SOLO* catheter.
It is primarily used to allow you to have special treatments over
a period of time. Having the PICC will make it more comfortable
for you because you will not have to have a needle inserted into
a vein over and over again.

The PICC can be used to give you special fluids, medications,

blood products, to take blood samples for testing, or contrast
power injections. Your doctor or nurse will explain the reasons
why you have this type of catheter.

Where does the PICC go

4 inside the body?
The PICC is inserted by the nurse or doctor into a vein in your
arm and threaded into a large vein that leads to your heart.

The catheter insertion site will need to have special care, which
will be explained later in this booklet.

Axillary Vein

Cephalic Vein
Basilic Vein

Accessory Median
CephalicVein Cubital Vein

Cephalic Vein Basilic Vein

a
94
py

= Indicates superficial
vein passing deep

= Indicates superficial
vein passing deep

3
 What is required to take care
5 of the PICC?

There are several things that you may need to do to care for
your PICC.
• Clean the insertion site and apply a clean dressing;
• Flush the catheter;
• Change the injection cap; and,
• Be able to detect problems and know what to do
when they occur.

Comments and/or changes as recommended by your nurse or

physician.
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 Site Care
a
Cleaning the insertion site and applying a clean dressing is usu-
ally referred to as “Site Care.” Site Care should be done on
a regular basis as ordered by your doctor. The frequency will
depend on the type of dressing, your general health, the type of
fluid being infused into the catheter, and the condition of your
skin. The doctor's orders may also be changed for any of these
reasons.

You will be instructed on how frequently to change the dressing.

You may need to change the dressing daily, three times a week
or weekly or if it becomes loose or soiled. Your doctor or nurse
will select the most appropriate supplies for your routine care.

The “Site Care” procedure is outlined here for reference pur-

poses only. Remember, you will receive instructions from your
doctor or nurse on all procedures and you should not attempt
any procedure alone until you feel confident that you can carry
out all of the steps.

Supplies you will need:

___ Sterile gloves
___ ChloraPrep* Solution One-Step Applicator
___ Sterile cover dressing (transparent or gauze)
___ Sterile 2 in. x 2 in. gauze dressings
___ Tape strips
___ Securement device (if needed)

1. Clean the work surface by wiping with a paper towel that

has been moistened with alcohol. Wipe dry or allow to air
dry. Then place supplies on the cleaned surface.

2. Wash your hands thoroughly using warm, soapy water.

Rinse completely and dry using a clean cloth towel or fresh
paper towels.

3. Carefully open the dressing kit, or unwrap supplies, without

touching the inside surfaces of the kits or wrappers.

5
4. Carefully remove the old dressing, pulling away from the
catheter hub and toward the insertion site. Remove the tape
or dressing carefully to avoid irritating your skin or pulling on
the catheter.

5. Wash your hands again.

6. Carefully observe the insertion site and the skin around it.
Look for redness or drainage. Measure the external length
of the catheter to ensure it has not gotten longer or shorter.
If you notice redness or drainage at the insertion site, have a
fever or notice that the external length of the catheter is lon-
ger or shorter, finish the dressing change and then call your
doctor or nurse.

7. Put on the pair of sterile gloves following the procedure you

were taught. After you have the gloves on and adjusted, do
not touch anything but the sterile supplies you will be using
to clean the insertion site.

8. Carefully clean the insertion site with a ChloraPrep* Solution

One-Step Applicator.

9. Pinch the wings on the applicator to break the ampule and

release the antiseptic. Do not touch the sponge. Wet
the sponge by repeatedly
pressing and releasing the
sponge against the treat-
ment area until liquid is
visible on the skin.

10. Use repeated back

and forth strokes
of the sponge
for approxi-
mately 30 sec-
onds. Completely
wet the treatment
area with antiseptic. Allow the area to dry for approximately
30 seconds. Do not blow or wipe away.

Note: Maximum treatment area for 1 applicator is approxi-

mately 4 in. x 5 in. Discard the applicator after a single use.

6
11. Some facilities place a securement device at this point.
Check with your nurse or doctor to see if this pertains to
your PICC.

12. Fold a 2 in. x 2 in. gauze in half and place it under the cath-
eter hub for padding (if needed), and apply tape strips.

13. Check to see that the catheter is not kinked or pinched.

Apply the cover dressing centering it over the insertion site,
following the directions in the package as well as instruc-
tions from your doctor or nurse.

14. Secure the catheter to the dressing or arm with tape. This
will prevent pulling of the catheter at the insertion site and
decrease irritation. To
help prevent possible
catheter occlusion,
coiling the catheter is
not recommended.

15. Always secure the

catheter in such a
way that you can eas-
ily see the cap end.
Your doctor or nurse will help you select the best method to
secure the catheter. The type of clothing and normal activ-
ity will need to be considered in this procedure. You should
periodically look at the capped end to be sure it is intact.

Comments and/or changes as recommended by your nurse

or physician.

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7
 Clamping the PICC
b
Under normal circumstances, your PICC will not need to be
clamped. If damage to the catheter occurs, the catheter should
be clamped immediately.

1. Use only smooth-edged clamps.

2. Follow the directions of your doctor or nurse

regarding when to clamp.

There are different kinds of clamps.

The “bulldog clamp” is a small, heavy wire clamp that opens

when the end is pinched. There are others that work in a scissor
fashion but have smooth-edged surfaces to protect the catheter.
Avoid use of surgical clamps or any clamps that have not been
approved by your doctor or nurse.

When should you clamp?

You should clamp if there is any damage to the catheter or the

catheter connector, or if there is any separation of the catheter
and the catheter connector: Always have a clamp available
for emergencies.

Comments and/or changes as recommended by your nurse

or physician.
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8
 Flushing the PICC
c
The PICC is flushed with normal saline to help clear the PICC
after receiving medications or having blood withdrawn for lab
tests. Your doctor or nurse will tell you when you need to flush
and with what solution. If the catheter is used only for periodic
treatments, you will need to flush the catheter once a week with
normal saline to keep it open and free of clots.

1. Flush the catheter after every use, or at least weekly when

not in use. Use a 10 ml or larger syringe.
2. Flush the catheter with a minimum of 10 ml of 0.9% sodium
chloride, using a “pulse” or “stop/start” technique. Use of
heparinized saline to lock each lumen of the catheter
is optional.

Note: Periods of increased physical activity may require more

frequent flushing of your PowerPICC SOLO* catheter. Consult
your nurse or physician for instructions.

There are pre-filled normal saline flush syringes available, or

you may be instructed on how to draw up normal saline from a
vial into a syringe. Do not use smaller than a 10 ml syringe
for flushing. Do not flush against resistance.

Supplies you will need:

• Alcohol or povidone iodine wipe.

• A 10 ml syringe filled with normal saline, and prepared
for use (your nurse or doctor will tell you how much nor-
mal saline to use).

The steps in the procedure are:

1. Wash your hands thoroughly.

2. Collect your supplies in a convenient place.

3. Using friction, clean the cap with an alcohol or povidone

iodine wipe. Allow the cap to air dry - be sure not to touch
the cap during this time. Do not blow on the area or allow
the clean cap to dangle since this increases the chance of 9
contamination of the area with bacteria.
4. If you are using a needleless adapter/safety needle follow
the instructions of your nurse or doctor to properly access
the injection cap or if you are using a needle, remove the
needle cover and carefully insert the needle into the center
of the catheter injection cap.

5. Using a 10 ml syringe, inject the normal saline into the cath-

eter. As you inject the last 1/2 ml of normal saline, withdraw
the needle/syringe from the injection cap.

6. Remove the needle and syringe from the injection cap.

Discard in a needle container.

Comments and/or changes as recommended by your nurse

or physician.
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 Changing the Injection Cap
d
The catheter injection cap is the only part of the system that you
will have to change. The injection cap is used for access and
therefore needs to be changed regularly. The frequency will
depend on how often your catheter is being used. Your doctor
or nurse will instruct you on how often you need to change your
catheter injection cap.

Supplies you will need:

1 - Sterile injection cap

1 - ChloraPrep* Solution One-Step Applicator
Normal saline
1 - Syringe

The procedure to change the injection cap:

1. Wash your hands thoroughly.

2. Open the package of the new injection cap and prepare

according to your instructions. Be sure the cap does not
touch the outer surface of the package.

NOTE: Pre-fill the injection cap with normal saline. Your

doctor or nurse will teach you this additional procedure.

3. Unscrew the old injection cap and discard, holding the cath-
eter adapter below the level of your heart. (The fluid level in
the catheter may drop part-way into the catheter if the con-
nector is held above the level of your heart).

4. Using a ChloraPrep* Solution One-Step Applicator, clean

around the hub where the injection cap was connected to
the catheter. Be careful not to touch the inside of the cath-
eter. Allow to air dry.

11
5. Pick up the new prefilled injection cap only by the top.
Attach the new injection cap by firmly screwing it onto the
catheter hub.

6. Repeat steps 3-5 for the second injection cap.

Comments and/or changes as recommended by your nurse

or physician.

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 Be able to Detect Problems and
e know what to do
Don’t expect problems but be prepared if they should occur.
The following is a list of potential problems with specific infor-
mation about each:

PROBLEM Infection
SIGNALS You may have a fever with a temperature over 100o
F, chills, swelling, or oozing at the insertion site. You may note a
foul odor, feel pain or heat from the insertion site. General fatigue
or decrease in activity in a child, even without fever, may indicate a
problem.

WHAT TO DO Call your doctor or nurse.

HOW TO AVOID IT Follow instructions at all times to avoid con-

taminating the catheter. Wash hands before beginning any proce-
dure. Wear a mask if you have a cold or a cough. Avoid persons
who are ill. Do your procedures in a well ventilated, but draft-free
place.

PROBLEM Phlebitis
SIGNALS You may have redness, tenderness or pain, increased
skin temperature, swelling, or the vein may feel hard. Some
patients experience an increased redness around the insertion site
about two weeks after the catheter has been inserted. This can be
a normal part of the healing process. The redness of normal heal-
ing is NOT accompanied by pain, and goes away in 24-48 hours.
Your doctor or nurse may suggest that you apply a warm compress
several times daily until the redness is gone.

WHAT TO DO Call your doctor or nurse.

HOW TO AVOID IT Avoid strenuous use of the arm your cath-

eter is in. Check your dressing regularly to make sure the catheter
remains secure. Change the dressing every seven days or if it
becomes soiled or loosened or as instructed by your doctor or nurse.

13
PROBLEM Breakage or separation of the Catheter,
extension leg, or catheter hub
SIGNALS There may be leaking of fluid when you flush the
catheter. You may be able to see the break or the separation of
the catheter above the junction, a broken extension leg, or sepa-
ration of the catheter hub from the extension leg.

WHAT TO DO If the catheter body breaks, bend the catheter

back on itself and tape securely. If there is not enough catheter
left to bend back on itself, carefully pull 1-2 inches of the cathe-
ter out from the site, then bend it back on itself and tape secure-
ly to your arm. Call your doctor or nurse. If the catheter breaks
on the extension leg, bend the extension leg on itself and tape
securely, call your doctor or nurse as this may be repairable.

HOW TO AVOID IT Do not over-twist the adapter when chang-

ing the injection cap. Do not use smaller than a 10 ml syringe
for flushing. Do not flush against resistance. Never have scis-
sors or sharp objects near the catheter.

PROBLEM Disconnected Injection Cap

SIGNALS The injection cap will be missing.

WHAT TO DO If you don’t have a clean injection cap, bend

the catheter back on itself and secure with a rubber band or
tape, otherwise clean the catheter adapter connection and
replace with a clean injection cap. Don’t use the same injection
cap. See changing injection cap instructions. Remove the tape
or rubber band. Call your doctor or nurse.

HOW TO AVOID IT Secure injection cap when replacing.

Check the injection cap after each use and periodically each
day, to ensure it remains tight and secure.

PROBLEM Loose Injection Cap

SIGNALS The injection cap will be loose and easily able
to turn.

WHAT TO DO Tighten the injection cap.

14
HOW TO AVOID IT Check the injection cap after each use and
periodically each day to ensure it remains tight and secure.

PROBLEM Occluded (Blocked) Catheter

SIGNALS Unable to flush the catheter using normal pressure.

WHAT TO DO DO NOT USE EXTRA PRESSURE. Call your

nurse or doctor. The catheter will need to be unplugged by your
nurse or doctor.

HOW TO AVOID IT Flush on a regular schedule, after every pro-

cedure is done, or when blood has backed up into the catheter.
NOTE: Periods of physical activity may require more frequent flush-
ing of your PICC. Consult your doctor or nurse for instructions.

PROBLEM Difficulty Drawing Blood

SIGNALS You may be able to flush the catheter easily but will
not be able to withdraw blood.

WHAT TO DO Call your doctor or nurse.

HOW TO AVOID IT This is caused by the body’s attempt to

wall off a foreign object by creating a fibrin sleeve around the
catheter. It cannot be avoided.

PROBLEM Air in the Catheter due to

Catheter Damage

SIGNALS You may see air in the catheter or hear air enter
the catheter. This may occur due to breakage or dislodgement
of the connections on the PICC. If sufficient air has entered the
catheter you may experience symptoms of shortness of breath,
chest pain or lightheadedness.

WHAT TO DO IF YOU FEEL SHORTNESS OF BREATH OR

CHEST PAINS, CALL 911. THIS IS A MEDICAL EMERGENCY.
Lie down on your left side or lie down with your feet well above
your chest.

15
If you are not experiencing any symptoms or are able to attend
to the catheter, immediately bend the catheter back on itself,
between the break and the skin insertion site, and secure it with
a rubber band or tape. If there is not enough catheter left to
bend it back on itself, carefully pull 1-2 inches of the catheter
out from the site, then bend it back on itself and tape securely
to your arm. Tape the remaining catheter securely to your arm.
Call assistance or see your doctor to have the catheter fixed or
removed as soon as possible.

HOW TO AVOID IT Do not use sharp objects near the cath-

eter. Do not leave catheter dangling from insertion site.
Make sure all catheter connections are tight and secure.

PROBLEM Swelling of Neck & Arm on side

of Catheter Insertion
(Central Vein Thrombosis)

SIGNALS You may notice swelling of your hand, arm, shoul-

der or neck on the side of the catheter insertion.

WHAT TO DO Call your doctor. He will need to see you as

soon as possible.

HOW TO AVOID IT This happens to a certain number of peo-

ple. The reason is unknown. Call your doctor or nurse.

PROBLEM Swelling at Exit Site

SIGNALS You will notice a lump increasing in size over the
insertion site and occurring shortly after the insertion procedure.

WHAT TO DO Apply gentle pressure over the dressing for a

few minutes. Put ice in a plastic bag and apply over the dress-
ing. Be sure not to get the dressing wet. Call your doctor or
nurse if the swelling continues.

HOW TO AVOID IT Follow instructions of your physician or

nurse regarding any restrictions of vigorous activities immedi-
ately after insertion.

16
 Questions Other Patients
6 Have Asked
How will I know that everything is okay?

When you look at the catheter and insertion site, and you
don’t see anything unusual, be confident that there are no
problems. Some patients experience an increased redness
around the insertion site about two weeks after the catheter
has been inserted. This can be a normal part of the healing
process. The redness of normal healing is NOT accompanied
by pain, and goes away in 24-48 hours. Your doctor or nurse
may suggest that you apply a warm compress several times
daily until the redness is gone. There should not be any
drainage around the catheter at this time. You will also know
that everything is okay if you can flush your catheter freely.

During the time you have the catheter, your doctor or nurse
may have you take your temperature every day and may
request that you make other periodic observations. This will
be another way of making sure everything is okay.

How will I know if something is wrong?

If you experience problems with the flushing procedure, you

may have a clotting problem which requires immediate atten-
tion by your doctor or nurse.

A low grade temperature and a feeling of general fatigue/

weakness that lasts for more than 24 hours may mean the
beginning of an infection. If a child becomes less active for
no apparent reason for longer than usual, an infection may be
starting even though there is no increase in temperature.

If you have a fever with a temperature higher than 100° F, call

your doctor or nurse immediately. Contact your doctor or
nurse as soon as you suspect that something is wrong.

17
Are there any special instructions when caring for a
child with a PICC?

Note: Periods of increased physical activity may require

more frequent flushing of your child’s PowerPICC SOLO*
catheter. Consult your nurse or physician for instructions.
There may need to be some activity limitations, especially
just after the PICC is inserted. Substituting quieter activity
is recommended instead of imposing activity restrictions.

The child should wear some type of close fitting clothing

covering the arm to help keep curious fingers from han-
dling the catheter. Not only is there a danger of pulling out
the catheter, but also of contamination of the insertion site
from excessive handling. This type of clothing will also
prevent the child from putting the catheter in his or her
mouth or from chewing on the catheter. It will be neces-
sary to look at the catheter under the clothing at intervals
during the day.

If the child is left in the care of a person who is not trained

in catheter care, a review of emergency procedures should
be done. This should be scheduled prior to the time the
person will care for the child. Also make sure that emer-
gency information and emergency phone numbers are
available for the care giver.

Can I bathe?

You should ask your doctor this question. The answer will
depend on your general health and general risk of infec-
tion. It will also depend on how long you have had the
catheter in place. The doctor may allow you to bathe as
long as you do not get the catheter dressing wet or damp.

18
Does the insertion site always need a bandage?

The insertion site should always have some type of dress-

ing or bandage on it. The type you use will depend on the
recommendation by your doctor and what works best for
you. The dressing should be changed every seven days
and as needed if the dressing is loose, soiled or damp, or
as instructed by your doctor or nurse.

What do I do if I get a cold or cough?

If you have a cold or cough, your doctor or nurse may

instruct you to wear a mask when you are caring for the
catheter, especially during the cap change and dressing
change procedures.

If I forget to flush on time, what should I do?

You should flush the catheter as soon as you remember.

Never force fluid into the catheter, especially if it has been
a while since you flushed. If you experience difficulty flush-
ing, contact your doctor or nurse immediately.

What happens if I can’t flush the catheter?

If you have difficulty flushing the catheter, check your cath-

eter to be sure that there are no kinks or other obstructions
in the catheter. DO NOT try to flush against resistance!

If the catheter is not kinked or obstructed and you still can-

not flush using the small amount of pressure that you have
been applying, contact your doctor or nurse immediately.
You may have a clot in the catheter. Never attempt to do
anything with the catheter that you were not taught to do.
You may dislodge a clot into the bloodstream or you may
damage the catheter.

19
What happens to the PICC if it is damaged?

After you have taken the precaution of bending the cath-

eter on itself and securing it with a rubber band or tape,
you will need to have it repaired or replaced. The repair
or replacement must be done using special equipment. If
there is not enough catheter left to bend it back on itself,
carefully pull out 1-2 inches of the catheter from the inser-
tion site. Tape the remaining catheter securely to your arm.

If I break the needle in the injection cap, what should I do?

Remove the injection cap and broken needle. Apply a new

injection cap as previously instructed and complete the
flushing procedure. If unable to remove the broken needle,
carefully pull out 1-2 inches of the catheter from the inser-
tion site, bend the catheter back on itself and tape down
securely. Call your doctor or nurse.

If I run out of supplies, what should I do?

Call the hospital, company, or pharmacy that is supplying

you with what you need. If you run out of supplies and
can’t reach your supplier, call your nurse, doctor or local
pharmacist for assistance. You should always have extra
supplies on hand so that you won’t run out.

If blood backs up into the catheter, is something

wrong?

Blood in the cap and catheter won’t hurt you but it may
enhance the growth of bacteria and increase the risk of
clotting or infections. Blood usually backs up into the cath-
eter only when there is increased internal pressure that is
created by some form of physical activity or bending over,
or if a clot is holding the valve open. If blood is noticed,
you should flush the catheter as soon as possible.

20
What happens if the catheter won’t come out when I
don’t need it anymore?

The catheter is removed

by pulling it out. The cath-
eter is made of a material
designed to easily slip in
and out of skin and blood vessels. The person removing
the catheter has been specially trained to handle the pro-
cedure and the rare problems that may occur.

What happens if the catheter breaks?

The part of the system that is most likely to break is the

end of the catheter that holds the injection cap. If this
should occur, immediately bend the catheter on itself
between the break and the skin insertion site, securing it
with a rubber band or tape. If there is not enough catheter
left to bend it back on itself, carefully pull out 1-2 inches of
the catheter from the site, then bend it back on itself and
tape securely to your arm. Tape the remaining catheter
securely to your arm. Call your doctor or nurse.

What happens if the catheter gets pulled out?

Since the catheter is anchored to your skin, it is highly

unlikely that it will come out unless it is pulled on. The
catheter may stretch a bit after it has been used a while,
and it may seem like it has slipped out. If you suspect
that the catheter is slipping out, call your nurse or doctor

If I have a treatment, do I need to flush the catheter?

The final step in any treatment done through the catheter

is a flush of some type. If the catheter has been flushed
following treatment, use that time as the last flush and
schedule your next flush at the recommended interval.
Be sure to check with your doctor or nurse, since the
flushing procedure varies depending on what the catheter
is being used for and your level of activity.

21
Can I engage in sexual activity when I have the catheter?

There is no prohibition against sexual activity because of

the catheter. Some safety precautions taken before you
begin any activity should be observed. The dressing at
the insertion site should be secure and the catheter should
be completely covered by the dressing and secured with
tape at the hub so it is not hanging free. If blood is noticed
in the catheter, flush it with 10 ml of normal saline.
Do not hesitate to discuss this with your doctor or nurse.

What should I do if I become allergic to tape?

There are other choices of hypoallergenic tapes that can

be used. It is important to be aware of any skin problems
near the insertion site because the danger of infection
increases if there is skin irritation.

Should I wear a medical alert type bracelet or have

some other information available regarding my cath-
eter?

It would be a very good idea to wear something to alert

others that you have a peripherally inserted central venous
catheter. If you were in an accident or became ill and
couldn’t give this type of information yourself, the bracelet
could be lifesaving by informing emergency personnel that
you have a catheter. There are commercial companies
that have medical alert bracelets or you may want to ask
for a hospital type plastic waterproof I.D. band as a tempo-
rary measure. Another option is the catheter Maintenance/
I.D. card given to you by your nurse or physician. Place
the card in your wallet and carry it with you at all times.

Should someone else learn the procedures?

Most people can not change a PICC dressing by them-

selves. Having another person available who has been
trained in all of the necessary procedures is important.
The most important thing is that someone else knows how
to do emergency procedures.
22
I’ve heard that some chemicals can hurt the catheter.
Is this true?

Some chemicals can damage the catheter. It is important

not to use anything near the catheter unless you check
with your doctor or nurse. Acetone, such as that found in
nail polish remover or some tape removers, is especially
harmful and should not be used.

How long can the catheter stay in place?

Your doctor is the best source for this answer. The cathe-
ter is designed to stay in place for long periods of time, but
each patient situation is unique. The answer depends on
what the catheter is used for, your general health, and the
care and attention paid to the procedures. The better care
you take of your catheter, the longer you may be without
complications.

Comments and/or changes as recommended by your

nurse or physician.
_____________________________________________________
_____________________________________________________
_____________________________________________________
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_____________________________________________________
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_____________________________________________________

“YOU CAN MAKE A DIFFERENCE!”

23
 Quiz
7
Answer the following questions by circling T for true or F
for false. The answers are on the next page.

1. If there is a break in the catheter, the first thing that I

should do is call the doctor.
T F
2. If the cap becomes loose, it should be tightened imme-
diately.
T F
3. If the cap falls off, replace it immediately.

T F
4. “Site Care” must be done between 9 and 10 a.m.

T F
5. It is okay to use more force during the flush procedure
to get the flow going.
T F
6. I can jog or do other activities as long as it is okay with
my doctor or nurse.
T F
7. To prevent contamination, I should keep the catheter
under my clothing and not disturb it between flushes.

T F
8. During the dressing change, if I notice that the catheter
has come out a little bit, I should push it back in.

T F

24
 Answers
7
1. False. The first thing to do is to bend the catheter
back on itself and secure with a rubber band or tape,
then call the doctor or nurse.

2. True.

3. False. The cap needs to be replaced but with a sterile

cap. If the same cap is reapplied there is an increased
risk of infection. Follow the full procedure for cap
change.

4. False. You can do “site care” at 3 a.m. if you wish,

as long as you do it on a regular basis and are alert
enough to do the procedure carefully.

5. False. You may dislodge a blood clot or rupture the

catheter which is dangerous. If you have difficulty
flushing, stop the procedure and call your doctor or
nurse.

6. True. The catheter should not interfere with your nor-

mal activity as long as you get permission for the activ-
ity from your doctor or nurse.

7. False. You should periodically look at the catheter,

especially if long periods of time elapse between flush-
es. This is especially true for the period of time imme-
diately following the insertion of the catheter.

8. False. You should call your doctor or nurse. Never try

to re-insert the catheter. This may lead to an infection.

25
Comments and/or changes as recommended by your
nurse or physician.

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26
 Catheter Information and
8 Supply List

Patient Name:_ _______________________________Date:_________

Base Line Right/Left Upper Arm Circumference was ____________cm.

Catheter French Size:_ _________ Product Code:_________________

Name of Catheter: _ ____________ Catheter Length cm:____________

Lot No.: _____________________ PICC was inserted via the Right/Left

Basilic/Cephalic Vein. Blood Return was Obtained/Not Obtained._____

______cm. of insertable catheter length exposed from insertion site.

Hospital:____________________________ Phone: ______________

Doctor:_____________________________ Phone: ______________

Nurse:_ ____________________________ Phone: ______________

Supplier:_ __________________________ Phone: ______________

List of Supplies Needed:

Dressing Supplies: Flushing Supplies:

_________________________ ____________________________
_________________________ ____________________________
_________________________ ____________________________
_________________________ ____________________________
_________________________ ____________________________
_________________________ ____________________________

Catheter Care Schedule: _ ___________________________________

SUN MON TUE WED THU FR I SAT

Site Care:

Flushing:

Cap Change:

Special Instructions:_ _______________________________________

________________________________________________________
27
 Acknowledgement Card
89 (Place in patient medical record)

I , _______________________________
have received the booklet -- How to Care
for your PowerPICC SOLO* Catheter --
from ______________________________.
(print name of person giving booklet to patient or care-giver)

________________________ ________
(signed) (date)

________________________ ________
(signed) (date)
ChloraPrep* Solution One-Step Applicator Active Ingredients
• Chlorhexidine gluconate 2% w/v...antiseptic
• Isopropyl alcohol 70% v/v...antiseptic

Inactive Ingredients
• USP purified water

For further information or questions regarding ChloraPrep* One-Step Applicator call:

1-800-523-0502 (8 a.m.-5 p.m. CST)

An issued or revision date for these instructions is included for user’s information. In the
event two years have elapsed between this date and product use, the user should contact
Bard Access Systems, Inc. to see if additional product information is available.

Revised Date: July 2007.

0714584 0707R

© 2007 Copyright C. R. Bard, Inc. All rights reserved.

*Bard, PowerPICC, PowerPICC SOLO, Power. Saline. One., and the color purple are trademarks and/or
registered trademarks of C. R. Bard, Inc. or an affiliate.
*ChloraPrep is a registered trademark of Enturia, Inc. or an affiliate.

Bard Access Systems, Inc.

Salt Lake City, Utah 84116
Toll Free Order Department: 1-800-545-0890
Clinical Information Hotline: 1-800-443-3385
www.bardaccess.com
www.powerpiccsolo.com