Bard PowerPICC SOLO 2, Patient Manual, Page: 6 / 108

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The steps in the procedure are:
1. Wash your hands thoroughly.
2. Collect your supplies in a convenient place.
3. Using friction, clean the cap with an alcohol or povidone iodine wipe. Allow the cap
to air dry - be sure not to touch the cap during this time. Do not blow on the area or
allow the clean cap to dangle since this increases the chance of contamination of
the area with bacteria.
4. If you are using a needleless adapter/safety needle follow the instructions of your
nurse or doctor to properly access the injection cap or if you are using a needle,
remove the needle cover and carefully insert the needle into the center of the
catheter injection cap.
5. Using a 10 ml syringe, inject the normal saline into the catheter. As you inject the
last 1/2 ml of normal saline, withdraw the needle/syringe from the injection cap.
6. Remove the needle and syringe from the injection cap. Discard in a needle
container.
Comments and/or changes as recommended by your nurse or physician.
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Changing the Injection Cap
The catheter injection cap is the only part of the system that you will
have to change. The injection cap is used for access and therefore
needs to be changed regularly. The frequency will depend on how
often your catheter is being used. Your doctor or nurse will instruct
you on how often you need to change your catheter injection cap.
Supplies you will need:
1 - Sterile injection cap
1 - ChloraPrep* Solution One-Step Applicator
Normal saline
1 - Syringe
The procedure to change the injection cap:
1. Wash your hands thoroughly.
2. Open the package of the new injection cap and prepare according to your
instructions. Be sure the cap does not touch the outer surface of the package.
NOTE: Pre-fill the injection cap with normal saline. Your doctor or nurse will teach
you this additional procedure.
3. Unscrew the old injection cap and discard, holding the catheter adapter below
the level of your heart. (The fluid level in the catheter may drop part-way into the
catheter if the connector is held above the level of your heart).
4. Using a ChloraPrep* Solution One-Step Applicator, clean around the hub where the
injection cap was connected to the catheter. Be careful not to touch the inside of
the catheter. Allow to air dry.
5. Pick up the new prefilled injection cap only by the top. Attach the new injection cap
by firmly screwing it onto the catheter hub.
6. Repeat steps 3-5 for the second injection cap.
Comments and/or changes as recommended by your nurse or physician.
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Be able to Detect Problems and know
what to do
Don’t expect problems but be prepared if they should occur. The
following is a list of potential problems with specific information
about each:
PROBLEM Infection
SIGNALS You may have a fever with a temperature over 100
o
F, chills, swelling, or
oozing at the insertion site. You may note a foul odor, feel pain or heat from the
insertion site. General fatigue or decrease in activity in a child, even without fever, may
indicate a problem.
WHAT TO DO Call your doctor or nurse.
HOW TO AVOID IT Follow instructions at all times to avoid contaminating the catheter.
Wash hands before beginning any procedure. Wear a mask if you have a cold or a
cough. Avoid persons who are ill. Do your procedures in a well ventilated, but draft-free
place.
PROBLEM
Phlebitis
SIGNALS You may have redness, tenderness or pain, increased skin temperature,
swelling, or the vein may feel hard. Some patients experience an increased redness
around the insertion site about two weeks after the catheter has been inserted. This
can be a normal part of the healing process. The redness of normal healing is NOT
accompanied by pain, and goes away in 24-48 hours. Your doctor or nurse may suggest
that you apply a warm compress several times daily until the redness is gone.
WHAT TO DO Call your doctor or nurse.
HOW TO AVOID IT Avoid strenuous use of the arm your catheter is in. Check your
dressing regularly to make sure the catheter remains secure. Change the dressing every
seven days or if it becomes soiled or loosened or as instructed by your doctor or nurse.
PROBLEM
Breakage or separation of the Catheter, extension leg, or catheter hub
SIGNALS There may be leaking of fluid when you flush the catheter. You may be able to
see the break or the separation of the catheter above the junction, a broken extension
leg, or separation of the catheter hub from the extension leg.
WHAT TO DO If the catheter body breaks, bend the catheter back on itself and tape
securely. If there is not enough catheter left to bend back on itself, carefully pull 1-2
inches of the catheter out from the site, then bend it back on itself and tape securely
to your arm. Call your doctor or nurse. If the catheter breaks on the extension leg, bend
the extension leg on itself and tape securely, call your doctor or nurse as this may be
repairable.
HOW TO AVOID IT Do not over-twist the adapter when changing the injection cap. Do
not use smaller than a 10 ml syringe for flushing. Do not flush against resistance. Never
have scissors or sharp objects near the catheter.
PROBLEM Disconnected Injection Cap
SIGNALS The injection cap will be missing.
WHAT TO DO If you don’t have a clean injection cap, bend the catheter back on itself
and secure with a rubber band or tape, otherwise clean the catheter adapter connection
and replace with a clean injection cap. Don’t use the same injection cap. See changing
injection cap instructions. Remove the tape or rubber band. Call your doctor or nurse.
HOW TO AVOID IT Secure injection cap when replacing. Check the injection cap after
each use and periodically each day, to ensure it remains tight and secure.
PROBLEM Loose Injection Cap
SIGNALS The injection cap will be loose and easily able to turn.
WHAT TO DO Tighten the injection cap.
HOW TO AVOID IT Check the injection cap after each use and periodically each day to
ensure it remains tight and secure.
PROBLEM Occluded (Blocked) Catheter
SIGNALS Unable to flush the catheter using normal pressure.
WHAT TO DO DO NOT USE EXTRA PRESSURE. Call your nurse or doctor. The catheter
will need to be unplugged by your nurse or doctor.
HOW TO AVOID IT Flush on a regular schedule, after every procedure is done, or when
blood has backed up into the catheter.
NOTE: Periods of physical activity may require more frequent flushing of your PICC.
Consult your doctor or nurse for instructions.
PROBLEM
Difficulty Drawing Blood
SIGNALS You may be able to flush the catheter easily but will not be able to withdraw
blood.
WHAT TO DO Call your doctor or nurse.
HOW TO AVOID IT This is caused by the body’s attempt to wall off a foreign object by
creating a fibrin sleeve around the catheter. It cannot be avoided.
PROBLEM
Air in the Catheter due to Catheter Damage
SIGNALS You may see air in the catheter or hear air enter the catheter. This may occur
due to breakage or dislodgement of the connections on the PICC. If sufficient air has
entered the catheter you may experience symptoms of shortness of breath, chest pain or
lightheadedness.
WHAT TO DO IF YOU FEEL SHORTNESS OF BREATH OR CHEST PAINS, CALL 911. THIS IS A
MEDICAL EMERGENCY. Lie down on your left side or lie down with your feet well above
your chest. If you are not experiencing any symptoms or are able to attend to the
catheter, immediately bend the catheter back on itself, between the break and the skin
d
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