Need info on PICC Lines

bigjay · Nov 30, 2002

Hi Duckie,

We handle a lot of PICC lines on my floor and they really aren't something to be worried about. His line will save him multiple poking for IV sites and bloodwork. In terms of monitoring for complications, just watch the site itself. If it looks red or leaky, get the nurse giving him his meds to check it out. PICC lines are usually pretty good and non-complicated.

In terms of daily maintainence, that varies slightly from institution to institution. The line will need to be hep-locked when not in use. Make sure he avoids getting it overly wet in the shower (use seran wrap on it to cover it) and that he doesn't get it caught on anything. It may or may not be sutured in... if it's not, be extra careful.

I can't really speak to hearing horror stories about Vanco... the fact that the PICC is a central line and won't go interstitial is nothing but a plus on that note though. I would imagine your husband must have a systemic MRSA infection if he's being treated this way... hope the anti-biotics kick it quickly.

Hope this helps.

**canoehead, BSN, RN** · Nov 30, 2002

We put warm packs on the upper arm Q4H for 24H to prevent venospasm and moniter the upper arm circumference Q8H for 24H and then daily to watch for clot or inflammation in the blood vessel.

NicuGal, MSN, RN · Nov 30, 2002

Vanco isn't as bad as most antibiotics, and thankfully he will have the PICC line :) They are pretty easy to care for. The visiting nurse should be the one to care for it. I have helped several girls in the unit, who had PICCS for chemo, and adult ones are much easier to take care of than little kids... LOL. Dressings are easier to change. Ask if the nurse is going to do that, or if eventually you will have to do it.

I just wanted to say good luck with the treatment!

duckie · Nov 30, 2002

Thanks for your input, it really relieves my mind to know that I have such a great bunch of nurses I can turn to on things I'm not sure of. Since we have 2 adorably spoiled and active critters, I will just request the LN wrap the line with gauze to keep them from accidently pulling on it. (they're brats, what can I say) They're already interested in his hands, from the smell of infection, even though he tries to always keep them covered, but I know they'll want to check out anything new. The initial dose will be given when they insert the PICC line. after that a nurse will come to the house daily, so it's possible I will have to flush the line. I'm just too close to this situation otherwise I could probably have been shown the procedure and done it but he's my everything so I want him in the best hands possible and this time, it's another nurse. I'll have to buy her something special for taking care of him. I'm a nervous wreck, got a knot in my gut, just want this over and him all better. Thanks again everyone, please keep him in your prayers. Love you all!!!! Duckie

BadBird, BSN, RN · Nov 30, 2002

Just remember to use nothing smaller than a 10cc syringe when giving meds or flushing, the 5cc or 3cc syringes have too much pressure and could rupture the line. I would flush with 10cc NS before administering the medication and 20 cc afterwards, observe for redness at site, difficulty flushing, always check for blood return.

Hope Mr. Duckie can paddle around the pond soon.

Agnus · Nov 30, 2002

Oh ducky I hear you. When it comes to my own.... Well I almost pass out at the sight of thier blood.

I went into total denial when my dad had a MI and I refused to get him to the hospital.

There should be a law that we can't care for our own.

Jenny P · Nov 30, 2002

Duckie, I will keep you two in my prayers as you requested. You are very wise to remain your DH's wife and not his nurse. My DH feels safest when I am his nurse; but it is becoming harder to do as his M.S. progresses and years of steroids have made his veins very fragile. It does rip my heart out each time that he blows another IV site; he still thinks I can get into his veins when the home health nurse can't; I refuse now and a special IV home health team comes out and does it.

As crazy as it sounds, I am a strong believer in the power of visualization and the mind body spirit connection. Have your Dear Hubby visualize the Vanco going into his body and destroying the MRSA (kind of like a video game with the Vanco as the good guys and the MRSA as the bad). The better he can do this, the better it should work.

Take care, Duckie. We will be thinking and praying for you.

We use PICC lines at work a lot; they have less problems than peripheral IVs. As BadBird says, never flush with a syringe smaller than 10ccs, I haven't seen a 5cc syringe rupture a line (when we started using PICCs, that was what we were using to flush); but the 10 cc size is what is reccommended now and that is what I'd stick to. As with any IV site, keep it clean and dry and inspect the site daily for redness, swelling, or drainage. My hospital uses tegaderm dressings so we can easily inspect the site and not disturb the dressing; the tegaderm dressing gets changed Q4D by the IV team using sterile technic. We flush the ports QD and PRN after meds. BTW, remember that Vanco needs to be infused for at least an hour as infusing Vanco too fast can cause Red Man Syndrome, a histamine reaction which may cause flushed face and neck, chills &/or fever, tachycardia, hypotension and hives. I've seen this reaction twice in my years of using it; and though it may look dramatic, it is easily prevented, responds to antihistamines, and you can pre-medicate with antihistamines in someone who has this reaction instead of discontinuing treatment.

oldgirl, RN · Nov 30, 2002

our Groshong piccs come with a booklet telling the patient how to take care of them. That brand also states that you should NOT use heparin for flushing. There are some that do use it though, so ask for any literature you can get at the time they insert it.

jemb · Nov 30, 2002

Duckie, you won't have any problem caring for the PICC line. I'll just reiterate the prior posts re keep the dressing dry, flush with saline before and after the abx, and then with heparin if it's not a Groshong. We tell our patients to flush twice a day, so that would be one additional flush besides the one after the Vanco, but he may get different instructions. My suggestion for keeping the critters from playing with the line would be to wrap the site in Coban, then cover it with a section of stockinette. We have patients come in once a week for dressing changes, unless there's aproblem with the site or the dressing gets wet and needs to be changed earlier. ((((((Hugs)))))) to both of you.