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insertion site, and secure it with a rubber band or tape. If there is not enough catheter left
to bend it 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. Tape the remaining catheter securely
to your arm. Call assistance or see your doctor to have the catheter fixed or removed as
soon as possible.
HOW TO AVOID IT Do not use sharp objects near the catheter. Do not leave catheter
dangling from insertion site. Make sure all catheter connections are tight and secure.
PROBLEM
Swelling of Neck & Arm on side of Catheter Insertion (Central Vein
Thrombosis)
SIGNALS You may notice swelling of your hand, arm, shoulder or neck on the side of the
catheter insertion.
WHAT TO DO Call your doctor. He will need to see you as soon as possible.
HOW TO AVOID IT This happens to a certain number of people. The reason is unknown.
Call your doctor or nurse.
PROBLEM
Swelling at Exit Site
SIGNALS You will notice a lump increasing in size over the insertion site and occurring
shortly after the insertion procedure.
WHAT TO DO Apply gentle pressure over the dressing for a few minutes. Put ice in a
plastic bag and apply over the dressing. Be sure not to get the dressing wet. Call your
doctor or nurse if the swelling continues.
HOW TO AVOID IT Follow instructions of your physician or nurse regarding any
restrictions of vigorous activities immediately after insertion.
Questions Other Patients Have Asked
How will I know that everything is okay?
When you look at the catheter and insertion site, and you don’t see
anything unusual, be confident that there are no problems. 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. There should not be any
drainage around the catheter at this time. You will also know that everything is okay if you
can flush your catheter freely.
During the time you have the catheter, your doctor or nurse may have you take your
temperature every day and may request that you make other periodic observations. This
will be another way of making sure everything is okay.
How will I know if something is wrong?
If you experience problems with the flushing procedure, you may have a clotting problem
which requires immediate attention by your doctor or nurse.
A low grade temperature and a feeling of general fatigue/weakness that lasts for more
than 24 hours may mean the beginning of an infection. If a child becomes less active for
no apparent reason for longer than usual, an infection may be starting even though there
is no increase in temperature.
If you have a fever with a temperature higher than 100° F, call your doctor or nurse
immediately. Contact your doctor or nurse as soon as you suspect that something is
wrong.
Are there any special instructions when caring for a child with a PICC?
Note: Periods of increased physical activity may require more frequent flushing of
your child’s PowerPICC SOLO* catheter. Consult your nurse or physician for instructions.
There may need to be some activity limitations, especially just after the PICC is inserted.
Substituting quieter activity is recommended instead of imposing activity restrictions.
The child should wear some type of close fitting clothing covering the arm to help keep
curious fingers from handling the catheter. Not only is there a danger of pulling out the
catheter, but also of contamination of the insertion site from excessive handling. This
type of clothing will also prevent the child from putting the catheter in his or her mouth
or from chewing on the catheter. It will be necessary to look at the catheter under the
clothing at intervals during the day.
If the child is left in the care of a person who is not trained in catheter care, a review of
emergency procedures should be done. This should be scheduled prior to the time the
person will care for the child. Also make sure that emergency information and emergency
phone numbers are available for the care giver.
Can I bathe?
You should ask your doctor this question. The answer will depend on your general health
and general risk of infection. It will also depend on how long you have had the catheter in
place. The doctor may allow you to bathe as long as you do not get the catheter dressing
wet or damp.
Does the insertion site always need a bandage?
The insertion site should always have some type of dressing or bandage on it. The type
you use will depend on the recommendation by your doctor and what works best for
you. The dressing should be changed every seven days and as needed if the dressing is
loose, soiled or damp, or as instructed by your doctor or nurse.
What do I do if I get a cold or cough?
If you have a cold or cough, your doctor or nurse may instruct you to wear a mask when
you are caring for the catheter, especially during the cap change and dressing change
procedures.
If I forget to flush on time, what should I do?
You should flush the catheter as soon as you remember. Never force fluid into the
catheter, especially if it has been a while since you flushed. If you experience difficulty
flushing, contact your doctor or nurse immediately.
What happens if I can’t flush the catheter?
If you have difficulty flushing the catheter, check your catheter to be sure that there are
no kinks or other obstructions in the catheter. DO NOT try to flush against resistance!
If the catheter is not kinked or obstructed and you still cannot flush using the small
amount of pressure that you have been applying, contact your doctor or nurse
immediately. You may have a clot in the catheter. Never attempt to do anything with the
catheter that you were not taught to do. You may dislodge a clot into the bloodstream
or you may damage the catheter.
What happens to the PICC if it is damaged?
After you have taken the precaution of bending the catheter on itself and securing it
with a rubber band or tape, you will need to have it repaired or replaced. The repair or
replacement must be done using special equipment. If there is not enough catheter left
to bend it back on itself, carefully pull out 1-2 inches of the catheter from the insertion
site. Tape the remaining catheter securely to your arm.
If I break the needle in the injection cap, what should I do?
Remove the injection cap and broken needle. Apply a new injection cap as previously
instructed and complete the flushing procedure. If unable to remove the broken needle,
carefully pull out 1-2 inches of the catheter from the insertion site, bend the catheter
back on itself and tape down securely. Call your doctor or nurse.
If I run out of supplies, what should I do?
Call the hospital, company, or pharmacy that is supplying you with what you need. If
you run out of supplies and can’t reach your supplier, call your nurse, doctor or local
pharmacist for assistance. You should always have extra supplies on hand so that you
won’t run out.
If blood backs up into the catheter, is something wrong?
Blood in the cap and catheter won’t hurt you but it may enhance the growth of bacteria
and increase the risk of clotting or infections. Blood usually backs up into the catheter
only when there is increased internal pressure that is created by some form of physical
activity or bending over, or if a clot is holding the valve open. If blood is noticed, you
should flush the catheter as soon as possible.
What happens if the catheter won’t come out when I don’t need it anymore?
The catheter is removed by pulling it out. The catheter is made of a material
designed to easily slip in and out of skin and blood vessels. The person removing the
catheter has been specially trained to handle the procedure and the rare problems that
may occur.
What happens if the catheter breaks?
The part of the system that is most likely to break is the end of the catheter that holds
the injection cap. If this should occur, immediately bend the catheter on itself between
the break and the skin insertion site, securing it with a rubber band or tape. If there is
not enough catheter left to bend it back on itself, carefully pull out 1-2 inches of the
catheter from the site, then bend it back on itself and tape securely to your arm. Tape
the remaining catheter securely to your arm. Call your doctor or nurse.
What happens if the catheter gets pulled out?
Since the catheter is anchored to your skin, it is highly unlikely that it will come out
unless it is pulled on. The catheter may stretch a bit after it has been used a while, and
it may seem like it has slipped out. If you suspect that the catheter is slipping out, call
your nurse or doctor.
If I have a treatment, do I need to flush the catheter?
The final step in any treatment done through the catheter is a flush of some type. If
the catheter has been flushed following treatment, use that time as the last flush and
schedule your next flush at the recommended interval. Be sure to check with your
doctor or nurse, since the flushing procedure varies depending on what the catheter is
being used for and your level of activity.
Can I engage in sexual activity when I have the catheter?
There is no prohibition against sexual activity because of the catheter. Some safety
precautions taken before you begin any activity should be observed. The dressing at the
insertion site should be secure and the catheter should be completely covered by the
dressing and secured with tape at the hub so it is not hanging free. If blood is noticed
in the catheter, flush it with 10 ml of normal saline. Do not hesitate to discuss this with
your doctor or nurse.
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