• 3 •
Tape Strip Securement Procedure
Single Lumen
Dual Lumen
1. Place 1st anchor tape over wings or bifurcation.
2. Cover site and 1st anchor tape with transparent dressing up to hub, but not over hub.
3. Place 2nd anchor tape sticky side up under hub and close to transparent dressing. Wedge tape between
hub and wings. Anchor only one hub of dual lumen catheter.
4. Chevron 2nd anchor tape on top of transparent dressing and place 3rd anchor tape over hub.
Caution: The catheter must be secured in place to minimize the risk of catheter breakage and
embolization.
WARNING: When using alcohol or alcohol containing antiseptics with polyurethane PICCs, care
should be taken to avoid prolonged or excessive contact. Solutions should be allowed to completely
dry before applying an occlusive dressing. Chlorhexidine gluconate and/or povidone iodine are the
suggested antiseptics to use.
WARNING: Alcohol should not be used to lock, soak or declot polyurethane PICCs because
alcohol is known to degrade polyurethane catheters over time with repeated and prolonged
exposure.
WARNING: Acetone and polyethylene glycol containing ointments should not be used with
polyurethane catheters, as these may damage the device.
Triple Lumen
1. Place 1st anchor tape over wings or trifurcation.
2. Cover site and 1st anchor tape with transparent dressing up to hub, but not over hub.
3. Place 2nd anchor tape sticky side up under hub and close to transparent dressing. Wedge tape
between hub and wings. Chevron anchor tape on top of transparent dressing.
4. Place 2nd and 3rd anchor tapes sticky side up under remaining hubs. Wedge tape between hubs
and wings. Chevron anchor tape on top of transparent dressing.
15. Verify Placement
• PICCs should be positioned with the catheter tip in the lower 1/3 of the SVC. Verify correct
catheter tip position using radiography or appropriate technology.
16. Power Injection Procedure
WARNING: PowerPICC SOLO*2 catheter indication for power injection of contrast media implies
the catheter’s ability to with stand the procedure, but does not imply appropriateness of the
procedure for a particular patient. A suitably trained clinician is responsible for evaluating the
health status of a patient as it pertains to a power injection procedure.
A. Remove the injection/needleless cap from the PowerPICC SOLO*2 catheter.
B. Attach a 10 ml or larger syringe filled with sterile normal saline.
C. Aspirate for adequate blood return and vigorously flush the catheter with the full 10 ml of sterile
normal saline.
WARNING: Failure to ensure patency of the catheter prior to power injection
studies may result in catheter failure.
D. Detach syringe.
E. Attach the power injection device to the PowerPICC SOLO*2 catheter per manufacturer’s
recommendations.
F. Contrast media should be warmed to body temperature prior to power injection.
WARNING: Failure to warm contrast media to body temperature prior to power injection may
result in catheter failure.
G. Use only lumens marked “Power Injectable” for power injection of contrast media.
WARNING: Use of lumens not marked “Power Injectable” for power injection of contrast media
may cause failure of the catheter.
H. Complete power injection study taking care not to exceed the flow rate limits. Do not exceed
the maximum flow rate of 5ml/sec.
WARNING: Exceeding the maximum flow rate of 5 ml/sec, or the maximum pressure of power
injectors of 300 psi, may result in catheter failure and/or catheter tip displacement.
WARNING: Power injector machine pressure limiting feature may not prevent over-
pressurization of an occluded catheter, which may cause catheter failure.
I. Disconnect the power injection device.
J. Replace the injection/needleless cap on the
PowerPICC SOLO*2 catheter.
K. Flush the
PowerPICC SOLO*2 catheter with 10 ml of sterile normal saline, using a 10 ml or
larger syringe. Use of heparinized saline to lock each lumen of the catheter is optional.
• The
PowerPICC SOLO*2 catheter testing included 10 power injection cycles.
17. Suggested Catheter Maintenance
A.
Dressing Changes
1. Assess the dressing in the first 24 hours for accumulation of blood, fluid or moisture
beneath the dressing. During all dressing changes, assess the external length of the
catheter to deter mine if migration of the catheter has occurred. Periodically confirm
catheter placement, tip location, patency and security of dressing.
2. Maintain according to hospital protocol. Avoid using acetone based solutions, or ointment.
These substances are known to degrade polyurethane.
3. Chlorhexidine gluconate is the suggested antiseptic to use. 2% Chlorhexidine gluconate
/70% isopropyl alcohol swab sticks may be used for dressing changes. Povidone-iodine
may also be used as an antiseptic.
4. Allow all cleaning agents / antiseptics to dry completely before applying dressing. Caution:
Acetone and tincture of iodine should not be used.
WARNING: When using alcohol or
alcohol containing antiseptics with polyurethane PICCs, care should be taken to avoid
prolonged or excessive contact. Solutions should be allowed to completely dry before
applying an occlusive dressing. Chlorhexidine gluconate and/or povidone iodine are the
suggested antiseptics to use.
B. Flushing
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.
3. Disconnect the syringe and attach a sterile end cap to the catheter hub and tighten
securely.
4. Prior to blood sampling when infusing TPN, follow routine maintenance procedure except
use 20 ml saline and flush to clear TPN from the catheter.
5. If resistance is met when flushing, no further attempts should be made. Further flushing
could result in catheter rupture with possible embolization. Refer to institution protocol
for clearing occluded catheters. NOTE: When injecting or infusing medications that are
incompatible, you should always flush the catheter with a minimum of 10 ml saline before
and after the medication. NOTE: When maintained in accordance with these instructions,
the PowerPICC SOLO*2 catheter does not require the use of heparinized saline to lock
the catheter lumens. However, use of heparinized saline will not adversely effect the
catheter and may be necessary based on patient status or use of alternate flushing and
locking techniques.
Caution: Always remove needles or needleless caps slowly while injecting the last 0.5 ml
of saline.
Caution: Use aseptic techniques whenever the catheter lumen is opened or connected to
other devices.
Caution: The PowerPICC SOLO*2 catheter is designed for use with a needleless injection
caps or “direct-to-hub” connection technique. Apply a sterile end cap on the catheter hub
to prevent contamination when not in use. Use of a needle longer than 1.6 cm may cause
damage to the valve.
WARNING: Alcohol should not be used to lock, soak or declot
polyurethane PICCs because alcohol is known to degrade polyurethane catheters over
time with repeated and prolonged exposure.
C. Occluded or Partially Occluded Catheter
Catheters that present resistance to flushing and aspiration may be partially or completely
occluded. Do not flush against resistance. If the lumen will neither flush nor aspirate and it
has been determined that the catheter is occluded with blood, a declotting procedure per
institution protocol may be appropriate.
D. When Cleaning the Exit Site
WARNING: Do not wipe the catheter with acetone based solutions or polyethylene glycol
containing ointments. These can damage the polyurethane material if used over time.
• Maintain according to hospital protocol. Avoid using acetone based solutions, or ointment.
These substances are known to degrade polyurethane.
• Use chlorhexidine gluconate or povidione iodine to clean the exit site around the catheter.
• Allow all cleaning agents/antiseptics to dry completely before applying dressing.
18. Central Venous Pressure Monitoring
• Prior to conducting central venous pressure (CVP) monitoring:
• Ensure proper positioning of the catheter tip.
• Flush catheter vigorously with sterile normal saline.
• Ensure the pressure transducer is at the level of the right atrium.
• It is recommended that a continuous infusion of saline (3 ml/hr) is maintained through the
catheter while measuring CVP to improve accuracy of CVP results.
• Use your institution’s protocols for central venous pressure monitoring procedures.
WARNING: CVP monitoring should always be used in conjunction with other patient assessment
metrics when evaluating cardiac function.
19. Catheter Removal
• Remove dressing and
StatLock* catheter stabilization device or tape securement strips.
• Grasp catheter near insertion site.
• Remove slowly. Do not use excessive force.
• If resistance is felt, stop removal. Apply warm compress and wait 20-30 minutes.
• Resume removal procedure.
• Examine catheter tip to determine that the entire catheter has been removed.
