Preparing and Caring for Your Midline or PICC Catheter With StatLock® Securement Device



You had a catheter inserted into a vein in your arm.  This handout was prepared to teach you about the care of your catheter.  If you have any questions or concerns, please feel free to ask your doctor or nurse.

 

What is a Midline or PICC Line?

 

A PICC (Peripherally Inserted Central Catheter) line is a flexible hollow tube placed in a vein in your arm, most often above the elbow.  The PICC line is about 18 to 24 inches long and goes into the large vein near your heart.  It can be left in for a longer period of time than a midline catheter. There will be one, two, or three lumens (IV access lines) at the end of the catheter where your medicine will be given and labs can be drawn.

 

A midline catheter is about eight inches long and goes to the level of your shoulder.  It is used as a short-term intravenous (IV) that can be kept in your arm up to 4 weeks.

 

Your catheter is secured in place by a special device called a StatLock® PICC Plus.  This device locks the catheter in place to prevent the catheter from coming out.  Around the catheter insertion site (where it enters your skin), there is an antimicrobial disc called BioPatch® that helps to prevent your line from getting infected.

 

How Do I Care For and Change the Dressing?

 

Nurses will check the insertion site 24 hours after placement.  If the dressing is wet, soiled, or loose, it will be changed.  While you are in the hospital, a nurse will change your dressing every 6 days or more often if the dressing becomes wet, soiled, or loose.  A friend or family member may be taught how to change the dressing for you at home.  At home, the dressing may be changed every 7 days.  If the transparent dressing, StatLock® device, or BioPatch® dressing becomes loose, wet, or soiled, the whole dressing must be changed. 

 

 

 

 

Supplies: Central Line dressing kits contain these items except where noted.

 

• Exam gloves (not included in central line kit)
• Alcohol pads
• Sterile gloves
• Alcohol swab sticks
• ChloraPrep® skin antiseptic
• Skin prep
• StatLock® PICC Plus kit
• BioPatch® (may need to be added based on which kit you get from your home infusion agency)
• Transparent dressing

 

How to change the sterile dressing

 

1.   Gather all supplies.

2.   Wash your hands well with soap and water for 30 seconds.

3.   Wearing a pair of exam gloves, remove the transparent dressing using ‘stretch-technique’ (roll the corners of the dressing furthest from the insertion site and pull outward lifting the transparent dressing up off the skin).  Use alcohol pads or swabs for easier release.

4.   Do not pull the transparent dressing off the insertion site and BioPatch®.  Leave in place until the StatLock® is removed.

5.   To unlock the catheter, follow these steps.

• Stabilize the catheter by placing a gloved finger over the transparent dressing at insertion site.
• Stabilize one side of the StatLock®’s doors with the thumb of the same hand pushing on the catheter.
• Open the opposite door using the overhang on the bottom of the door (not the center).
• Switch hands and repeat.
• Gently remove the catheter from the StatLock®.
• Gently tape the catheter to the skin off to the side using medical tape.

6.   Using alcohol, soak an edge of the StatLock® until a corner is lifted.  Allow the alcohol to seep under the pad and dissolve the adhesive.   Do not force or pull the pad off, let the alcohol do the work to dissolve the adhesive.

7.   Use an alcohol pad to separate the dressing from the BioPatch® to avoid pulling the catheter out.  Remove the transparent dressing and BioPatch®.  Be sure to secure the catheter.

8.   Look at the insertion site for redness, swelling, or drainage.  Check to see if the catheter has moved out of the skin.   If it has slipped out more than an inch call your home care nurse.  NEVER try to slip the catheter back in the vein, because it may give you an infection or kink your catheter.

9.   Remove exam gloves and wash your hands.

10.  Open sterile supplies, including StatLock® kit and put on sterile gloves.

11.  Remove dried blood or debris with alcohol wipes or swabs.

 

 

12.  Activate the ChloraPrep® applicator to release the liquid into the sponge pad or swab.  Do not touch the pad.  Gently press the sponge against the skin near the catheter PICC site until you can see the liquid on the skin.  Use a back-and-forth friction rub for 60 seconds to all skin and catheter areas being covered by the dressing.  Take care to clean the catheter and wings on both sides.  Let air dry.  Do not blot, wave at, or blow-dry the area.

 

 

13.  Apply skin protectant where the StatLock® anchor and transparent dressing will touch the skin.  Allow to dry.  

14.  Place the BioPatch® dressing around the catheter site – blue, grid side up; foam side down on skin.  To make it easy to remove and to best cover the area around the catheter, the BioPatch® dressing slit should be placed slightly off center from the catheter at 5 or 7 o’clock (catheter itself is considered 6 o’clock).

15.  Loosen doors of the StatLock® by opening and closing them once.  Make sure the paper backing is not stuck to back of the StatLock®.

16.  Place catheter wing securement holes over posts of the StatLock® and close plastic doors one at a time.  Do not press on the patient.

17.  Place anchor pad over prepped securement site.  Peel away paper liner, one side at a time, pressing the pad in place.

18.  Apply sterile transparent dressing over site.

19.  Apply dressing change label to indicate when the dressing is to be changed.

 

Example of Correctly Dressed PICC Site

 

 

 

 

 

 

 

 

How Do I Flush the Midline or PICC Line?

 

Your line should be flushed every day and after each use.  Your nurse may advise you to flush more often if needed. 

 

 

Supplies

 

• 10 mL Normal Saline Flushes
• Safesite valve and cap
• Sharps^® container

 

1. Remove the plastic cover from the syringe.  Push the air out of the syringe.  Remove the valve cap.  Connect the syringe filled with saline to the end of the valve.  Twist on completely.  If the tip of the syringe touches anything other than the end of the catheter, stop, and replace the syringe
2. Unclamp your catheter.
3. Push gently and steadily on the plunger until the syringe is empty, clamping the catheter as you complete the flushing.  The line should flush easily.  If you find it is hard to push the fluid in, check to make sure the clamp is open and that the catheter is not kinked.  If it is still hard to push the fluid in, do not force the plunger.  Call your home care nurse.
4. Remove the syringe.  Put on a new valve cap.  Discard the syringe in the sharps container.  At home, you may double bag syringes without needles.
5. The valve will need to be changed once or twice a week depending on how often you use your line.  Use an alcohol swab to clean the hub of the catheter before placing a new reflux valve.
6. If your PICC line is used for blood draws, it needs to be flushed with 10 ml normal saline after each blood draw.
7. If you are going home with your line, be sure to flush with saline before and after your medicine.

 

Benefits to these lines are

• Comfort – When you have a line, you may not need to be stuck for frequent IV changes or most lab draws.
• Independence – The line may allow you to have your treatment at home instead of in the hospital.
• Safety – Because the line may be left in place longer than a standard IV, it helps to save your veins and keep the ones not being used for IVs in good shape.

 

Things to remember when you have a Midline or PICC

 

• Avoid having your blood pressure taken on the arm with the line.
• Close the clamp when catheter is not in use.
• Do not re-use valve caps.
• Call your home care nurse if you get a fever of 100.4º F or 38º C.
• Call your home care nurse if you notice swelling, redness, or pain at the catheter insertion site or anywhere up the arm.
• Wrap your arm in plastic wrap to cover the line and keep the Safe Site valve from getting wet when you shower.  Glad® Press and Seal works well.  Be sure to change your dressing or the valve if you feel it got wet in the shower.
• Change the dressing and StatLock^® device any time it gets wet, loose, or soiled.
• Your PICC line may be used for blood draws.
• Midlines are not used for blood draws.
• Do NOT use scissors to remove the dressing.  It may help to use an alcohol swab to loosen the adhesive.
• If you are on a pump, put your tubing under your clothing so it does not get caught on furniture.
• If the PICC or Midline breaks, put a belt or tourniquet snugly on your upper arm near your shoulder and go to the closest emergency room.  Your infusion company may provide you with a Dravon® clamp.
• Problems, though rare, do occur.  If you have any questions about your line, please contact your doctor or home care nurse.

 

 

Nurse: ________________________________________________________

 

Doctor: _____________________________________________________

 

Phone: _______________________________________________________

 

Name of Home Care Company: __________________________________

 

Home Care Company Phone Number: ______________________________

 

Date Catheter Inserted: _________________________________________

 

Vein Used: ____________________________________________________

 

Catheter Brand: ________________________________________________

 

Catheter Lot Number: ___________________________________________

 

Catheter Fr/Gauge: _____________________________________________

 

Trimmed Catheter Length: _______________________________________

 

Date of Last Dressing Change: ____________________________________

 

Tip Location: ___________________________________________________

 

Summary for Home Care

 

What	If NO Medicines infuse through PICC	If medicines will infuse through PICC
Dressing change	Every 7 days and anytime the dressing or BioPatch dressing becomes wet, loose or soiled	Every 7 days and anytime the dressing becomes wet, loose or soiled
Flush	At least every day	Use SAS method with each medicine.  Saline Administer medicine Saline
Change SafesiteÒ valve	Every 3-7 days	Every 3-7 days
Valve Caps	New valve cap each time you use PICC line.	New valve cap each time you use PICC line.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 08/17/2010

Copyright © 05/01/2008 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #5093

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