Re: PICC reaction vs infection
Not sure if this applies, but in the NICU, we do PICC lines constantly.
Here is our infection control measures:
1. PICC line placed via sterile procedure using Chlorhexidine Gluconate to prep the site.
2. PICC dressing is only changed in 24 hours if the dressing is dirty...if it's a scant amount of blood.....no change is made unles the dressing is dirty or coming off.
3. No access to PICC's or INT's unless site is cleaned with Chlorhexidine Gluconate for 15 seconds and allowed to dry for 30 seconds..and I'm not kidding you when I say..yes, we do follow that to the letter.
4. Cap changes are done by the RN's under full sterile procedure every 72 hours...that means, mask, gown, sterile gloves, etc.
5. PICC's that are pulled or just pulled out are also done under sterile procedure.
Yes, it is alot but our infection rates and culture rates are virtually zero in our department..we will actually go for months without getting one.
I do know all our tips we have been able to get cultures on have been negative. Yes we use ultrasound to place our PICCS. I wouldnt place one without it.. and when I first started we used to place without ultrasound. Nothing like poke and hope you didnt hit the artery. I am going to check out the websites you have given me and will also e-mail you for the cheat sheet. The nurses on the floor try to give good care but we are in a situation where we are expected to do more with less and it is frustrating all around. Thanks again. I have read alot of your posts and value the information you give. 
I have directed some of my coworkers to this website also. Hope to see them on here. 
Nursing News