Removal of a PICC line in home

Jazzyjazz · Oct 11, 2014

Not speaking from experience. I have a friend that I worked with at a private HH and she was told it was ok to remove picc lines in home. She recently got a job at another hospital based HH where she was told that it is a HUGE no no. They have radiology remove the line to make sure that nothing is left behind.

I guess it depends on the agebcy that you work for.

caliotter3 · Oct 11, 2014

Some agencies take more license with the licenses of their nurses than others do. Not something I would want to do in the home for reason stated in previous post.

SassyTachyRN · Oct 11, 2014

I worked oncology for several years and we removed them right on the floor, never sent them to radiology or had IV nurses remove them. Never did post removal scans. Just removed, applied an occlusive dressing not to be removed for 24 hours, did lots of teaching, and that was that.

amoLucia · Oct 11, 2014

I worked oncology for several years and we removed them right on the floor, never sent them to radiology or had IV nurses remove them. Never did post removal scans. Just removed, applied an occlusive dressing not to be removed for 24 hours, did lots of teaching, and that was that.

Worked LTC. This was how I did it in places where I worked.

njgrl622 · Oct 12, 2014

I'm a Home Infusion RN and have removed many PICC lines in the home. Slowly pull the line and then apply pressure to the site if there is bleeding. Never sent a patient for a scan after removal - like schoolRNapril said - apply an occlusive dressing and instruct the patient to keep it dry and intact for 24 hours. Even though the patient is on coumadin, if you gently and slowly pull the line, there should only be minimal bleeding....

edmia, BSN, RN · Oct 12, 2014

I think it totally depends on the agency's protocol. In home hospice we d/c these all the time. We were all trained in the procedure of course.

IVRUS, BSN, RN · Oct 20, 2014

Yes,

PICC's are pulled by a qualified nurse in a home setting, as long as there are policies which delineate the steps and that the nurse doing the removal is competent and qualified to remove it. A PICC should NOT be removed in a home setting if it is known or is suspected to be involved in a thrombus, and the one doing the removal should know the exact length of the IV catheter before its removal. Your policy should cover these points and have recommendations for complication management. Our policy states that the PICC arm should be lower than the heart and it should be removed in slow, increments to avoid spasms. In addition, once removed from the vascular system, a petroleum based ointment/with gauze should cover and occlude the insertion site to prevent skin to vein track air emboli.

Hope this helps!

LemonIndiscretion · Dec 15, 2014

I've removed a few in the home, to do so I need to see the xray and I need measurements, I pull then measure to make sure nothing is left behind, then apply occlusive dressing

dah doh, BSN, RN · Dec 15, 2014

It depends on your facility's policy. We are allowed to discontinue PICC lines as long as the doctor orders it. Pull slowly in case vein spasms, apply occlusive dressing after hemostasis, measure catheter length & examine catheter tip to see if it's intact. No additional tests required.

Pretty much the same technique if patient pulls their own PICC out...usually they are confused or agitated! Oops!

KelRN215, BSN, RN · Dec 16, 2014

We pull PICCs all the time in the home. Pull the line, measure it to ensure that the entire line has been removed, cover the site and go on with your day. When I worked in the hospital, we pulled them on the floor ourselves too. If the entire length of the original catheter is measured, there's no reason for any sort of radiologic studies.

Lauren21bk · Apr 22, 2015

You should check with the board of nurses in your state. In Louisiana PICC lines can only be removed in the home by PICC certified RN's.