PICC dressing changes tips & tricks

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I do a lot of PICC dressing changes at my job. I am doing these dressing changes by myself and have no trouble except for the Biopatch! The blue sticker on the Biopatch sticks to the tegaderm and then I have been trying to rip the tegaderm to get that blue sticker off. This makes me so nervous because when it rips, it's fast. No line has been pulled out or anything, I'm just hoping for some seasoned nurse tricks to make this easier, short of using scissors (kidding of course... no scissors!).

Thanks. :nurse:

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Specializes in ICU/CCU.

Are you not changing the biopatch along with the tegaderm? It is my understanding that the biopatch is supposed to pull off along with the tegaderm when the old dressing is removed. This is why we are taught not to tuck the biopatch under the line.

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Please, please, please do NOT tuck the biopatch under the line or use the notch in it to wrap around the line. It makes it near impossible for one nurse to remove the tegaderm without compromising the PICC line itself. Sorry for the rant. It's my current soap box.

I have no fantastic tips for you except for when you notice you will have an issue, have another set of sterile hands with you to help.

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Specializes in Infusion Nursing, Home Health Infusion.

The Biopatch and the entire dressing has to be applied correctly to function at its best and also the assist the clinician in an easy removal. . This is is the order in which I do a dressing change in a nutshell...I change my caps first and do a 15 sec hub scrub with site scrub or you can use CHG or IPA pads..then I remove the dressing ..steri strips, Biopatch and stat loc...sterile gloves on...then cleanse with CHG...allow to air dry..apply lots of skin prep..then I put on the stat loc first as this will allow you to apply the Biopatch with some ease. Now open the radial slit of the Bioptach and apply it to the skin with smooth side towards skin..do not just set it on the skin..rather line the radial slit up with the catheter. so there is no gap and it make contact with the PICC/CVC..so it is all lined up...if you do not do it this way...it is very difficult to remove and you can easily pull the the PICC ot a few cms with each dressing change. Remember the average length of the SVC is only 7 -7.5 cms..so if you lose a few cms with every dressing change it will not be long before you are out of the SVC altogether. Once you are lined up properly its much easier to pull off the TSM dressing. What type of TSM dressing are you using? There is one Tegaderm product that is made for pts with very moist skin / diaphoretic skin.... it has a lot of adhesive in the dressing. If that is the product you are using..YES your TSM dressing will stick to the biopatch and you will need to change the product.

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Specializes in LTC, PCU, QA & IC, Ocology.

I have found if you use alcohol and rub the tegaderm it releases the adhesive which makes it easier to remove. I agree with nursetastic, please do not wrap the notch under the Picc line just place it notch downward that way when you are pulling it off it cones off easier.

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Sorry, maybe I was unclear.

I know that the slit on the Biopatch should line up with the catheter to make it easier to remove. I am by myself changing these dressings, and TOO MANY are coming in with the slit somewhere else, making it really difficult to remove the dressing easily. I was hoping somebody would have some tips on how to remove it more easily, because it's really a pain (and kind of makes me nervous when I'm struggling), and like I said I am the ONLY one there, so I don't have the luxury of another set of hands. Hope that clears things up. Maybe there is no trick to easily removing a misplaced Biopatch during the dressing change, in which case... ugh.

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Specializes in ICU/CCU, PICU.

The slit is not supposed to line up under the catheter but slighty to the side of it. Most bacteria is located underneath is catheter. Placing the biopatch at a slight angle will ensure correct HCG contact with skin.

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My questions is: Is there a way to get the dressing off more easily without compromising the catheter? I do not have another set of sterile hands to help me.

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Specializes in Infusion Nursing, Home Health Infusion.

OK the only reason I started with the Biopatch is b/c if applied correctly it is so much easier to get the TSM dressing off with ease. The best way I have found to take the TSM dressing off is by pulling it off from either side....I never pull from the top or bottom..that way I can secure the catheter as I pull off the TSM. I am lucky in that only our IV nurses apply PICC dressing . On the Biopatch I open the radial slit and orient in such a manner that the catheter is lined up with it so the slit is towards the end of the catheter or you can lift the catheter slightly over it near the slit..and the edges of the slit need to meet. its difficult to explain but you can see pictures in the product insert or on line. Yes you can moisten it with NS but then it puffs up and I can always get them off with ease IF they have been applied correctly...if not I line up the slit with the catheter or find the slit and very carefully dewrap it without pulling any catheter out.

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