Strategies for Difficult Line Removals

Persistent Resistance During Withdrawal
•    Reposition the patient or affected limb

With some PICCs, resistance may be related to vasospasm.  Continuous heat promotes vasodilation, which will make the removal easier
•    Replace dressing and tape catheter
•    Apply continuous heat to the venous pathway from insertion site up to axilla for 10 minutes
•    Other tips include applying a warm compress to the patient’s hand or giving them a warm beverage
•    Reattempt removal
•    If still met with resistance, apply a dressing to the site and reattempt in 12-24 hours

Catheter Breaks During Withdrawal

•    If the catheter breaks during removal but is still long enough to be pulled, clamp the catheter and continue removal
•    If the catheter breaks in the patient’s vein: immobilize the arm and keep the patient still. Place the patient in Trendelenburg position and contact IVR immediately