Difficult PICC Removals

[James Wilken]

We find that we are having an increase in the number of PICCs that are difficult to remove and requiring the application of heat and time to facilitate removal. When in the past we had maybe one or two a year, we have recently had at least 6 in the past month. We always use Bard's Groshong PICC, 4fr 5 fr. All were optimally placed above the ACF in basilic vein. The patients are from different services so are medical, surgical, oncology etc. male/female, with varied duration of insertion from days to weeks. PICCs have been inserted either by palpation or by ultrasound. All by MST method. We have only recently (in the past few months) begun to use ultrasound for inserts. We do use latex gloves with powder but rinse the powder off before handling the PICC, however find that we are using multiple pairs of gloves for the procedure in order to set up sterile field etc. We do the inserts with one person, no assistants. Any suggestions as to why this could be happening? Thanks in advance for sharing your ideas with us. Patrice Wilken Vascular Access Team Nurse Winnipeg