{"id":53465,"date":"2026-07-08T09:45:00","date_gmt":"2026-07-08T08:45:00","guid":{"rendered":"https:\/\/campusvygon.com\/uk\/?p=53465"},"modified":"2026-06-23T11:48:32","modified_gmt":"2026-06-23T10:48:32","slug":"article-7-picc-removal-complications-and-post-removal-care","status":"publish","type":"post","link":"https:\/\/campusvygon.com\/uk\/vascular-access\/fundamentals-of-picc-practice\/article-7-picc-removal-complications-and-post-removal-care\/","title":{"rendered":"Article 7: PICC Removal, Complications and Post\u2011Removal Care"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Peripherally Inserted Central Catheters (PICCs) should be removed promptly when they are no longer clinically indicated or if they pose a risk to the patient. Early removal reduces the likelihood of complications such as infection and thrombosis (Loveday, 2014). Removal must only be undertaken by a competent practitioner with the appropriate knowledge and skills to ensure patient safety.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This section outlines safe removal practice, potential complications, and essential post\u2011procedure care.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Safe Removal of a PICC<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Prior to the procedure, the patient must be appropriately prepared. This includes confirming identity, explaining the procedure clearly, and obtaining informed consent. Effective communication helps to reduce anxiety and promotes cooperation during removal.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Equipment Required<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A clean, organised environment is essential. The following equipment should be prepared:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Dressing trolley cleaned with a disposal bag attached<\/li>\n\n\n\n<li>Plastic apron<\/li>\n\n\n\n<li>Sterile basic dressing pack<\/li>\n\n\n\n<li>Sterile gloves<\/li>\n\n\n\n<li>Skin cleaning product<\/li>\n\n\n\n<li>Transparent, semi\u2011permeable, occlusive dressing such as IV3000\u00ae<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Patient Preparation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Before commencing removal:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Check patient identity<\/li>\n\n\n\n<li>Explain the procedure<\/li>\n\n\n\n<li>Gain informed consent<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Patient Positioning<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Correct positioning reduces the risk of complications such as air embolism and facilitates smooth removal:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Position the patient so the exit site is below heart level<\/li>\n\n\n\n<li>Ensure patient comfort<\/li>\n\n\n\n<li>Support the arm with a pillow<\/li>\n\n\n\n<li>Ensure adequate lighting and ventilation<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Preparation of Equipment<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Perform hand hygiene using soap and water or alcohol hand rub if hands are visibly clean<\/li>\n\n\n\n<li>Open the sterile pack onto the cleaned dressing trolley<\/li>\n\n\n\n<li>Drop all required equipment onto the sterile field<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Removal of the Existing Dressing and Securement<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Decontaminate hands and apply clean gloves<\/li>\n\n\n\n<li>Securement device as per the indications of the device<\/li>\n\n\n\n<li>Carefully remove the dressing from the bottom upwards to avoid accidental catheter displacement<\/li>\n\n\n\n<li>Remove gloves and dispose of them safely<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Cleaning the Site<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Perform hand hygiene<\/li>\n\n\n\n<li>Apply sterile gloves<\/li>\n\n\n\n<li>Place a sterile drape beneath the PICC<\/li>\n\n\n\n<li>Clean the exit site using a suitable skin cleaning product, using a back\u2011and\u2011forth and up\u2011and\u2011down motion<\/li>\n\n\n\n<li>Allow the area to dry fully before proceeding<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Catheter Removal Process<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The removal should be performed slowly and carefully:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Place a sterile swab just above the insertion site<\/li>\n\n\n\n<li>Apply gentle traction and withdraw the catheter in a steady, continuous motion<\/li>\n\n\n\n<li>Always pull close to the insertion site to maintain control<\/li>\n\n\n\n<li>Apply gentle pressure during and after removal to prevent bleeding<\/li>\n\n\n\n<li>Confirm haemostasis before reducing pressure<\/li>\n\n\n\n<li>Apply a sterile dressing, either gauze with a bioclusive dressing or a bioclusive dressing alone<\/li>\n\n\n\n<li>Apply a bandage if clinically indicated<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Completion of the Procedure<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Once the catheter is removed:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If infection is suspected, cut the catheter tip and place it in a sterile container for culture and sensitivity testing<\/li>\n\n\n\n<li>Remove gloves and dispose of them immediately<\/li>\n\n\n\n<li>Perform hand hygiene<\/li>\n\n\n\n<li>Document the procedure thoroughly<\/li>\n\n\n\n<li>Observe the patient and provide instructions regarding potential oozing and dressing removal<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Potential Complications of PICC Removal<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Although PICC removal is generally low risk, complications can occur and practitioners must remain vigilant.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Mild bleeding or oozing at the removal site is common. Excessive bleeding may indicate clotting abnormalities or vessel injury and requires prompt assessment.<\/li>\n\n\n\n<li>Air embolism is a rare but serious complication. It may occur if air enters the venous system during removal. Proper positioning and maintaining an occlusive dressing reduce this risk.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Catheter Resistance or Breakage<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Resistance during removal may indicate thrombosis or vessel spasm. The catheter should never be forcibly removed, as this could result in catheter breakage or embolisation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Post\u2011Procedure Patient Care<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Ongoing care following PICC removal is essential to ensure patient safety and detect any complications early.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Infection:<\/strong> If the PICC site appears inflamed, painful, or discharging, infection should be suspected. Send the catheter tip for laboratory analysis is essential in these cases.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Venous Spasm or Pain:<\/strong> Some patients may experience discomfort or resistance during removal due to venous spasm. Slow, steady traction and reassurance can help alleviate this.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Observation<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Monitor the site for bleeding, swelling, or signs of infection<\/li>\n\n\n\n<li>Check patient observations if clinically indicated<\/li>\n\n\n\n<li>Ensure haemostasis is maintained<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Dressing Care<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Advise the patient to keep the dressing clean and dry<\/li>\n\n\n\n<li>The dressing should remain in place for at least 24 hours, unless otherwise indicated<\/li>\n\n\n\n<li>Inform the patient that slight oozing may occur and when to seek advice<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Patient Education<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Patients should be provided with clear instructions on:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Recognising signs of infection such as redness, swelling, or fever<\/li>\n\n\n\n<li>Reporting excessive bleeding or pain<\/li>\n\n\n\n<li>When to remove or change the dressing<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Documentation<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Accurate documentation should include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Date and time of removal<\/li>\n\n\n\n<li>Condition of the site<\/li>\n\n\n\n<li>Integrity of the catheter (ensuring it is removed intact)<\/li>\n\n\n\n<li>Any complications encountered<\/li>\n\n\n\n<li>Patient tolerance of the procedure<\/li>\n\n\n\n<li>Post\u2011procedure advice given<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Summary<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Safe removal of a PICC requires careful preparation, adherence to aseptic technique, and close attention throughout the procedure. Understanding potential complications and delivering appropriate post\u2011removal care are essential to minimise risks and ensure optimal patient outcomes. Competence, vigilance, and clear communication with the patient underpin safe and effective practice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Peripherally Inserted Central Catheters (PICCs) should be removed promptly when they are no longer clinically indicated or if they pose a risk to the patient. Early removal reduces the likelihood of complications such as infection and thrombosis (Loveday, 2014). Removal must only be undertaken by a competent practitioner with the appropriate knowledge and skills to [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":53472,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[117],"tags":[47],"class_list":["post-53465","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fundamentals-of-picc-practice","tag-picc-fr"],"acf":[],"_links":{"self":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/53465","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/comments?post=53465"}],"version-history":[{"count":3,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/53465\/revisions"}],"predecessor-version":[{"id":53558,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/53465\/revisions\/53558"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/media\/53472"}],"wp:attachment":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/media?parent=53465"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/categories?post=53465"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/tags?post=53465"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}