Caring for Jay’s PICC Line

Procedure Time!

The PICC line was a surprise for us. Of course, the whole Leukemia diagnosis was a bombshell, but the PICC was a new world as well. 

PICC stands for peripherally inserted central catheter. It is basically a semi-permanent IV. The PICC is a tube that is thicker and longer than an IV. 

It was placed in Jay’s upper arm. The tube went deep into one of Jay’s veins. There was a tube that hung out about six inches from her arm with a cap on it. 

A sterile bandage held the tube in place so it wouldn’t accidentally get pulled out.

Nurse Mom

Because of the distance we had to travel, the nurses gave me a crash course in caring for the PICC line. It needed to be flushed with solution twice a day to prevent it from getting clogged. 

The first thing was to wash my hands. Always a big thing with Jay’s treatment whether it was caring for the PICC or giving her medications. 

I laid everything out so I was organized and didn’t forget any steps (slightly OCD here...paranoid?...maybe forgetful?...).  

There are two types of solutions that can be pushed into her PICC line. One had a blue top and one had a yellow top. I think one lasted longer than the other, but the blue top ones were what we mostly used.

Anyway, the items I laid out were an alcohol prep pad, a new green cap, the syringe of solution, and a pair of gloves. 

The first thing was to put on a pair of gloves. Jay’s PICC line was always supposed to have a screw on cap to keep the line closed. 

I would remove the cap. Then I would clean the end of where the cap screwed onto the PICC with the alcohol wipe. Then I would either have Jay hold the line up so it wouldn’t hang and get dirty or I would juggle it while I opened the syringe. (When I got really good I would remember to unwrap the syringe from the titanium plastic before I started.) 

It was important to make sure the air bubble in the syringe was gone, so I’d have to squeeze the syringe a little till the liquid came out. 

It’s kind of like on movies where they prepare the needle and shoot out a lot of liquid to show that it’s ready. But you don’t really need to push out that much, just the air bubble.

 Of course, my first few times was exactly like the movies. The little plunger thingy on the syringe would stick for the first little bit. I’d try to push it just a little; it would stick, so I’d push it a little more. Then all of a sudden it would just go and pump out a whole bunch. As I practiced it, I got better. 

My husband didn’t do it very much, so I would give him bucket loads of crap over how much solution he just wasted.

Alright, enough of that. The syringe screws onto the end of the PICC line. Then I just push the fluid in at a steady pace. Once the syringe was empty, I’d put a new, clean cap back on the end of the PICC line and that was that. It took all of five minutes, twice a day, for three months...

Home Health

There was a home health nurse that would come by once a week to change the bandage on the PICC. Jay had to wear mask, the nurse wore a mask, and anyone who was in the room had to wear a mask.

They used sterile gloves and were really careful about keeping everything clean while they changed the bandage. The PICC is a direct line to the heart, so the risk of infection is pretty high.

Getting the bandage off was another of the fights I had with Jay. She didn’t like how the adhesive pulled on her skin and acted like it was yanking all of her skin off. 

At Primary Children’s they have this awesome spray bottle of adhesive remover that Jay loved. 

Unfortunately, the home health nurse didn’t have the same thing. So we had to work around Jay’s procrastination techniques and just get it done.

Showering with a PICC

Another thing about the PICC line is you can’t get it wet. Water and bandages don’t mix. The hospital gave us some big, plastic arm gloves to wrap it with, but those weren’t very practical for a five year old's little arm. All I did was keep her hand high on the wall during her bath.

Being Active with a PICC

Did I mention the several inches of tubing that stuck out of Jay’s arm? It would flap around. It would get caught in her clothes when she was putting her shirt or jacket on. It was in the way. 

My solution was to crochet a little sleeve that Jay could slide onto her upper arm (bicep) that would trap the dangling nuisance in place. This made life a lot easier for her. It also protected the PICC line from the energies of a five year old.

The PICC line was great for the nurses to push medications through, but it was also a lot of maintenance. Fortunately it was a short term solution. Things got better with the port.