PICC Line Complications: Common Issues and How To Prevent Them

If you’ve been recently diagnosed to require a PICC line, it can be overwhelming. To avoid PICC line complications, it’s important to know how to take care of yourself while wearing a PICC line, such as keeping it clean and hygienic with PICC line dressing changes.

Infection

The first thing to be wary of with your PICC line is the possibility of infection. The area where it goes into the vein is prone to infection, as the break in the skin gives germs access into your body. Most of the germs that can infect the PICC line come from your skin, so keeping the area around the catheter clean is paramount.

The PICC line will have a dressing to protect it from possible contamination from fluid, dirt, and germs. We recommend using IV Clear from Covalon as the dressing to use to keep your line clean, especially for people with sensitive skin. Your nurse or doctor will change the dressing for you, and this should be done approximately every seven days.

Things to do to help prevent an infection:

• Be sure to practice good hand hygiene by washing your hands with soap and water, and using alcohol-based hand gels.
• Your clinician should also do this. You should feel comfortable speaking up about this to your clinician if they are not following proper hand hygiene steps.
• The line should also be kept dry at all times. Find the best ways to take a shower while keeping the dressing dry. If you get the dressing wet, contact your doctor immediately. And lastly, try avoiding touching the line, even after washing your hands.

Should you see any redness, pain or swelling near the catheter site, or feel any pain or tenderness along the path of the catheter, this could be symptoms of a local infection. See your doctor without delay in such a case. If allowed to persist, this could result in bacteremia, a severe and possibly fatal condition where germs get into the bloodstream.

Disloding The Cathether

One of the more common problems with PICC lines is getting it displaced, with the line coming out, or even breaking and splitting. To prevent this, you should avoid activities that stress the arm or involve a lot of arm movement.

You might want to go easy when you are in the gym and avoid lifting heavy weights. We don’t recommend abandoning exercise, but it should be light and don’t involve a lot of arm movement. 

If you’re a student, make sure to avoid carrying heavy backpacks as well.

In severe instances, the catheter may become damaged and even result in a catheter malposition, where the line no longer ends up going to the intended target. Should this happen, the PICC line will have to be removed and replaced.

Getting Air in the Line

PICC lines usually have valves and caps at the end to stop air from coming in. The cap should always be closed when the line isn’t in use to prevent air from getting inside.

Air in the line can cause an air embolism, a potentially serious condition where air gets into the veins. While it takes a large amount of air (50 ml or more) to cause problems, it’s best to minimize risk. Simply avoid touching or manipulating the valves on your line, and this should be enough to prevent air from getting in. 

The most common symptoms of an air embolism are a sudden onset of breathlessness, nausea, and shoulder or chest pain. Should you experience any of these symptoms, you should see your healthcare provider immediately.

Blood Clots

A blood clot may form in the vein; this is a condition known as thrombosis. These clots can lead to an inflammation of the veins, or phlebitis. If you notice swelling in your arm where the line is inserted, or redness and tenderness, this could be a formation of a blood clot.

Superficial thrombophlebitis, while it sounds quite scary, isn’t a serious condition and can be resolved with home treatment such as warm compresses and over-the-counter anti-inflammatory medications like ibuprofen, but it can be painful. Your doctor may give you medication to treat the blood clot. The bigger risk is when the clot occurs in a deep vein, where the clot may embolize or break off and travel to the lungs. 

You can minimize the risk of a blood clot forming by ensuring proper circulation in your arms. If you are sedentary for long periods of time, make it a point to stand up and move around every couple of hours, and keep yourself hydrated drinking plenty of water. 

Living with a PICC line isn’t convenient, but with a little care, you can go about your normal life with little incident. With proper information and care you can minimize the risk of complications, so be sure to talk with your doctor and discover what works best for you.

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