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Important Care & Maintenance Advice

All vascular access devices MUST have an appropriate Care & Maintenance document completed daily.

Post insertion, PICC lines must have a 24 hour dressing change to remove non-transparent dressing and replace with an occlusive transparent semipermeable dressing.

Dressing changes for all central venous vascular access devices must be done weekly (unless visibly contaminated). The dressing, Statlock (if PICC line) and VADsite must all be changed weekly using ANTT.

When accessing a vascular access device to flush, aspirate or change VADsite you must always 'scrub the hub' for 30 seconds. Whilst scrubbing the hub you should concentrate on the flat connective surface but also scrub around the side using wipes that contain Chlorhexadine 2% and Alcohol 70%.

 

Preventing catheter blockages.

When flushing any central venous catheter, routinely use Nacl 0.9% in a 10ml syringe and a brisk 'push/pause' technique. This creates a turbulent pulsatile flow which will keep the catheter patent. Ensure that you finish the flush on positive pressure. Clamp the device as you are administering the last push. Flush before, between and immediately after each use.

There is no requirement to 'lock' catheter with heparin if the line is accessed daily.

Please refer to NHS GG&C VAD Guidelines.

Difficultly aspirating catheter.

  • Valsalva Manoeuvre - ask the patient to take a deep breath, hold and attempt to force out air through closed mouth.
  • Check the clamp on PICC line, move clamp and massage lumen underneath if crushed.
  • Please refer to  Appendix 4: Algorithm for persistent withdrawal occlusion of the RCN Standards for infusion therapy

Please do not remove a blocked PICC until you have spoken to a member of the Vascular Access Team as it may be salvageable.