Verbal consent must be given by the patient and clearly documented by the person performing the procedure.

• sterile pack
• chlorhexidine 2% in 70% alcohol sponge applicator
• sterile gloves (nitrile or latex)
• bandage.

Please note: if your hands are not socially clean and you need to wash your hands with soap and water (rather than alcohol gel), this must be carried out a minimum of 2 meters away from the working surface/dressing trolley and any CVAD equipment.

1. Explain procedure to patient and reassure them that this is normally a simple uncomplicated procedure. Check patients NEWS, full blood count and if clinically required a coagulation screen.
2. Clean hands with alcohol gel as per the WHO 5 moments for hand hygiene and prepare equipment.
3. Make the patient comfortable with arm supported on a pillow and the insertion site below the level of the heart. This minimises the risk of air embolism.
4. Loosen the existing dressing
5. Apply apron.
6. Clean hands with alcohol gel as per the WHO 5 moments for hand hygiene. Put on sterile gloves.
7. Remove dressing, SecurAcath or griplok (Click here to access SecurAcath manufacturers removal advice) and antimicrobial chlorhexidine sponge disc dressing. Clean the site with chlorhexidine 2% in 70% alcohol sponge applicator for 30 seconds and allow to dry for 30 seconds.
8. Hold a piece of gauze above the excision site to support the surrounding skin.
9. Apply traction on the PICC and gently pull the catheter in a steady and even manner moving the hand along the length of the PICC and pulling from the insertion point.
10. When the line is completely removed sterile gauze should be held over the insertion/ excision site point, apply gentle finger pressure until any bleeding stops.
11. Once any bleeding has stopped replace the gauze with further sterile dressing and then bandage the site; this will act as a pressure bandage and will minimise the risk of a haematoma formation.
12. Tip of Catheter must be sent to microbiology for culturing.
13. Carry out and record NEWS.
14. Remove PPE and dispose as per local policy.
15. Clean hands with alcohol gel as per the WHO 5 moments for hand hygiene.
16. Ensure that patient is left comfortable and aware of any effects that may result from PICC line being removed.
17. Follow up appointment given if required.
18. Referred to community nursing service for aftercare if required; ensure appropriate information given to community staff.
19. 19. Document the removal of line in patient’s notes, venous access surveillance system and PICC care plan / diary and record any complications. Anti-coagulation treatment commenced due to a PICC line may now be stopped under medical advice. Antibiotic therapy may be prescribed on doctors instructions.
20. Remove dressing in 24hrs.

1. If resistance is encountered when removing the line then it is usually due to venospasm within the arm; stop traction on the catheter; apply a warm compress to the arm for 20 minutes to encourage venous dilation.
2. Again attempt to remove line, do not stretch the PICC line or add undue pressure as the line may break. Always inspect the line after removal and ensure it is the same length as was documented at time of insertion.
3. If problems removing PICC cannot be resolved, seek advice from medical staff. Referral for removal under fluoroscopy may occasionally be necessary.