Registered nurses should be instructed in this technique. Swaddle the baby to decrease discomfort when removing the dressing. Grasp the catheter and pull slowly in small increments, pulling each time by positioning fingers back at the insertion site. If a culture is desired, this process must occur sterilely. It should take 30-60 seconds to remove the catheter. Inspect the catheter tip for breakage and cut tip off with sterile scissors into a sterile container to send for culture if indicated. Otherwise, simply measure the length of the catheter removed and document the removal process and amount of catheter removed.

If resistance to removal is encountered, stop the process. Prep the site with betadine, rinse with sterile water and redress. A heel warmer may be applied and removal may be attempted several hours later. A resource nurse should be notified.

If a PICC line is noted to be leaking around the hub or if the catheter is torn, a resource person should be consulted to repair the catheter. Registered nurses instructed in this technique are designated as resource nurses.

One person wearing a mask should hold the catheter in place externally by putting gentle pressure with one fingertip on the vein above the insertion site outside the sterile field while comforting the baby. Another person should prepare a sterile field and wear sterile gloves, mask, hair cover. The dressing should be removed as described above. A repair kit should be ordered. If changing the blue hub does not resolve the leaking or occlusion the pin may need to be replaced. To remove the pin, cut the catheter proximal to the damaged area. Carefully slide the pin from the discarded catheter. Insert the pin into the cut end of the catheter. Slide the catheter evenly onto the pin. Insert the pin/catheter into the blue hub until the pin is completely enclosed in the blue hub. Do not remove the blue hub from the clear tubing to avoid losing the washer contained in the blue hub. Place a new clave on the end of the new clear tubing. Flush with heparinized saline, observe for any other damage prior to applying a new dressing.

A repair kit may be required if the clear tubing hub is cracked. A repair kit contains a blue hub and clear extension tubing. Document procedure and amount of catheter that was cut.