Bard PowerPICC SOLO 2, Руководство для пациента, Страница: 5 / 108

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Site Care
Cleaning the insertion site and applying a clean dressing is usually
referred to as “Site Care.” Site Care should be done on a regular basis
as ordered by your doctor. The frequency will depend on the type of
dressing, your general health, the type of fl uid being infused into the
catheter, and the condition of your skin. The doctor’s orders may also be changed for any
of these reasons.
You will be instructed on how frequently to change the dressing. You may need to change
the dressing daily, three times a week or weekly or if it becomes loose or soiled. Your
doctor or nurse will select the most appropriate supplies for your routine care.
The “Site Care” procedure is outlined here for reference purposes only. Remember, you
will receive instructions from your doctor or nurse on all procedures and you should not
attempt any procedure alone until you feel confi dent that you can carry out all of the
steps.
Supplies you will need:
___ Sterile gloves
___ ChloraPrep* Solution One-Step Applicator
___ Sterile cover dressing (transparent or gauze)
___ Sterile 2 in. x 2 in. gauze dressings
___ Tape strips
___ Securement device (if needed)
1. Clean the work surface by wiping with a paper towel that has been moistened with
alcohol. Wipe dry or allow to air dry. Then place supplies on the cleaned surface.
2. Wash your hands thoroughly using warm, soapy water. Rinse completely and dry
using a clean cloth towel or fresh paper towels.
3. Carefully open the dressing kit, or unwrap supplies, without touching the inside
surfaces of the kits or wrappers.
4. Carefully remove the old dressing, pulling away from the catheter hub and toward
the insertion site. Remove the tape or dressing carefully to avoid irritating your skin or
pulling on the catheter.
5. Wash your hands again.
6. Carefully observe the insertion site and the skin around it. Look for redness or
drainage. Measure the external length of the catheter to ensure it has not gotten
longer or shorter. If you notice redness or drainage at the insertion site, have a fever or
notice that the external length of the catheter is longer or shorter, fi nish the dressing
change and then call your doctor or nurse.
7. Put on the pair of sterile gloves following the procedure you were taught. After you
have the gloves on and adjusted, do not touch anything but the sterile supplies you
will be using to clean the insertion site.
8. Carefully clean the insertion site with a ChloraPrep* Solution One-Step Applicator.
9. Pinch the wings on the applicator to break
the ampule and release the antiseptic. Do
not touch the sponge. Wet the sponge by
repeatedly pressing and releasing the
sponge against the treatment area until
liquid is visible on the skin.
10. Use repeated back and forth strokes
of the sponge for approximately
30 seconds. Completely wet the
treatment area with antiseptic.
Allow the area to dry for
approximately 30 seconds. Do
not blow or wipe away.
Note: Maximum treatment
area for 1 applicator is
approximately 4 in. x 5 in. Discard
the applicator after a single use.
11. Some facilities place a securement
device at this point. Check with your nurse or doctor to see if this pertains to your
PICC.
12. Fold a 2 in. x 2 in. gauze in half and place it under the catheter hub for padding (if
needed), and apply tape strips.
13. Check to see that the catheter is not kinked or pinched. Apply the cover dressing
centering it over the insertion site, following the directions in the package as well as
instructions from your doctor or nurse.
14. Secure the catheter
to the dressing or
arm with tape. This
will prevent pulling
of the catheter at the
insertion site and
decrease irritation. To
help prevent possible
catheter occlusion,
coiling the catheter is
not recommended.
15. Always secure the catheter in such a way that you can easily see the cap end. Your
doctor or nurse will help you select the best method to secure the catheter. The
type of clothing and normal activity will need to be considered in this procedure.
You should periodically look at the capped end to be sure it is intact.
Comments and/or changes as recommended by your nurse or physician.
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Clamping the PICC
Under normal circumstances, your PICC will not need to be clamped.
If damage to the catheter occurs, the catheter should be clamped
immediately.
1. Use only smooth-edged clamps.
2. Follow the directions of your doctor or nurse regarding when to clamp.
There are diff erent kinds of clamps.
The “bulldog clamp” is a small, heavy wire clamp that opens when the end is pinched.
There are others that work in a scissor fashion but have smooth-edged surfaces to
protect the catheter. Avoid use of surgical clamps or any clamps that have not been
approved by your doctor or nurse.
When should you clamp?
You should clamp if there is any damage to the catheter or the catheter connector, or
if there is any separation of the catheter and the catheter connector: Always have a
clamp available for emergencies.
Comments and/or changes as recommended by your nurse or physician.
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Flushing the PICC
The PICC is fl ushed with normal saline to help clear the PICC after
receiving medications or having blood withdrawn for lab tests. Your
doctor or nurse will tell you when you need to fl ush and with what
solution. If the catheter is used only for periodic treatments, you will
need to fl ush the catheter once a week with normal saline to keep it open and free of
clots.
1. Flush the catheter after every use, or at least weekly when not in use. Use a 10 ml or
larger syringe.
2. Flush the catheter with a minimum of 10 ml of 0.9% sodium chloride, using a
“pulse” or “stop/start” technique. Use of heparinized saline to lock each lumen of the
catheter is optional.
Note: Periods of increased physical activity may require more frequent fl ushing of your
PowerPICC SOLO* catheter. Consult your nurse or physician for instructions.
There are pre-fi lled normal saline fl ush syringes available, or you may be instructed on
how to draw up normal saline from a vial into a syringe. Do not use smaller than a
10 mL syringe for fl ushing. Do not fl ush against resistance.
Supplies you will need:
• Alcohol or povidone iodine wipe.
• A 10 ml syringe fi lled with normal saline, and prepared for use (your nurse or
doctor will tell you how much normal saline to use).
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