PICC dressing change with 3M Tegaderm with CHG

[utah23LPN]

I always cringe when I have to do a dressing change with the current PICC having the “gooey” 3M CHG!! It always seems to stick to the PICC line and pull it out when trying to remove it. Any tips or pointers for this type of PICC dressing?  Maybe they didn’t think of removing it when they developed the system.

[IVRUS, BSN, RN]

https://multimedia.3m.com/mws/media/993615O/picc-cvc-chg-device-application-guide.pdf

Maybe their website instructions can help

[Jennifer,RN]

Use a 10 cc saline syringe and squirt a little bit at a time on the CHG part. It helps! I work on a floor where most of our people have PICC lines. I absolutely hate when the PICCs are Stat locked vs being stitched in. I feel your pain. Yikes! 

[londonflo]

1 hour ago, Jennifer,RN said:

Use a 10 cc saline syringe and squirt a little bit at a time on the CHG part

If the PICC gets wet it will increase the risk of infection.

[Jennifer,RN]

4 hours ago, londonflo said:

If the PICC gets wet it will increase the risk of infection.

It will dry. You don't drench the whole area with the whole 10cc, you use a little bit at a time for the CHG gel that's difficult to remove. The website itself says to use an alcohol pad or normal saline to remove the CHG gel. This is the practice we use on the floor that I work on where the majority of my patients have PICC lines.  Furthermore, you are cleansing the site with Chlorhexidine after the fact, anyway. 

[kp2016]

Working outpatient infusions in a very hot state one Summer I noticed the first time we changed the dressing on the newly placed PICC lines the dressing's were incredibly sticky and hard to remove. Most of PICCs were placed by a mobile PICC team who drove around between multiple small hospitals in our area.  

It was my guess that the kits were left in hot cars during lunch breaks or maybe overnight and the high heat in the car affected the dressings. I was told by the PICC nurses and management that I was wrong and imagining this issue. Strangely the dressings from our supply cupboard that we used for our weekly dressing changes did not seem to have this problem. 

We took to having two staff to do the dressing change (many of my fellow RNs also imagined the same issue), one to hold the PICC and insure it didn't migrate in or out and the other to get the old dressing off and place the new one.