Peripherally inserted central catheter - flushing

  • Description
    • You have a peripherally inserted central catheter (PICC). This is a tube that goes into a vein in your arm. It helps carry nutrients or medicine into your body. It is also used to take blood when you need to have blood tests.

      You need to rinse out the catheter after every use. This is called flushing. Flushing helps keep the catheter clean. It also prevents blood clots from blocking the catheter.

  • Alternative Names
    • PICC - flushing

  • What to Expect at Home
    • Follow your provider's instructions on how to flush your catheter. A family member, friend, or caregiver may be able to help you with the flushing. Use this sheet to help remind you of the steps.

  • Supplies You will Need
    • Your doctor will give you a prescription for the supplies you will need. You can buy these at a medical supply store. It will be helpful to know the name of your catheter and what company made it. Write this information down and keep it handy.

      To flush your catheter, you will need:

      • Clean paper towels
      • Saline syringes (clear), and maybe heparin syringes (yellow)
      • Alcohol or chlorhexidine wipes
      • Sterile gloves
      • Sharps container (special container for used syringes and needles)
  • How to Flush Your Catheter
    • Before starting, check the labels on the saline syringes, heparin syringes, or medicine syringes. Make sure the strength and dose are correct. Check the expiration date. If the syringe is not prefilled, draw up the correct amount.

      You will flush your catheter in a sterile (very clean) way. This will help protect you from infection. Follow these guidelines:

      1. Wash your hands for 30 seconds with soap and water. Be sure to wash between your fingers and under your nails. Remove all jewelry from your fingers before washing.
      2. Dry with a clean paper towel.
      3. Set up your supplies on a clean surface on a new paper towel.
      4. Put on a pair of sterile gloves.
      5. Remove the cap on the saline syringe and set the cap down on the paper towel. DO NOT let the uncapped end of the syringe touch the paper towel or anything else.
      6. Unclip the clamp on the end of the catheter and wipe the end of the catheter with an alcohol wipe.
      7. Screw the saline syringe to the catheter to attach it.
      8. Inject the saline slowly into the catheter by gently pushing on the plunger. Do a little, then stop, then do some more. Inject all the saline into the catheter. DO NOT force it. Call your doctor if it is not working.
      9. When you are done, unscrew the syringe and put it in your sharps container.
      10. Clean the end of your catheter again with a new wipe.
      11. Put the clamp on the catheter if you are done.
      12. Remove the gloves and wash your hands.

      Ask your doctor if you also need to flush your catheter with heparin. Heparin is a medicine that helps prevent blood clots.

      Follow these steps:

      1. Attach the heparin syringe to your catheter, the same way you attached the saline syringe.
      2. Flush slowly by injecting a little at a time, the same way you did the saline.
      3. Unscrew the heparin syringe from your catheter. Put it in your sharps container.
      4. Clean the end of your catheter with a new alcohol wipe.
      5. Put the clamp back on the catheter.
  • Other Care
    • Keep all of the clamps on your catheter closed at all times. It is a good idea to change the caps at the end of your catheter (called the "claves") when you change your dressing and after blood is drawn. Your provider will tell you how to do this.

      Ask your doctor when you can shower or bathe. When you do, make sure the dressings are secure and your catheter site is staying dry. DO NOT let the catheter site go under water if you are soaking in the bathtub.

  • When to Call the Doctor
    • Call your health care provider if you:

      • Are having trouble flushing your catheter
      • Have bleeding, redness or swelling at the site
      • Develop swelling in the arm below the catheter
      • Notice leaking, or the catheter is cut or cracked
      • Have pain near the site, or in your neck, face, chest, or arm
      • Have signs of infection (fever, chills)
      • Are short of breath
      • Feel dizzy

      Also call your doctor if your catheter:

      • Is coming out of your vein
      • Seems blocked
  • References
    • Smith SF, Duell DJ, Martin BC, Aebersold M, Gonzalez L. Peripherally inserted central catheter (PICC). In: Smith SF, Duell DJ, Martin BC, Aebersold M, Gonzalez L, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2016:chap 29.6.