Dressings are a transparent semi-permeable membrane type. Dressings over PICCs are not routinely changed. PICC lines are not sutured in and can be easily pulled out with dressing removal. Dressings should be changed only when the integrity of the dressing is compromised, i.e. the dressing is non-occlusive, the dressing is restrictive compromising flow through the catheter or the patients’ circulation, visibility through the dressing is wholly inadequate, and/or there is drainage under the dressing (other than clotted blood from initial insertion.)

Registered nurses who have been instructed in this technique are designated as resource nurses. A resource nurse or NNP should be asked to change the dressing.

Dressing changes should be a two-person procedure done under sterile technique while wearing sterile gloves and masks. Swaddle the baby to decrease discomfort. One person should hold the catheter in place externally by putting gentle pressure with one finger tip on the vein above the insertion site outside the sterile field while comforting the baby. The opsite and all steri-strips should be removed by pulling toward the insertion site. The area should be cleansed with betadine swabs and rinsed with sterile water. Alcohol causes damage to the silicone tubing and should not be used. The amount of external catheter should be measured and documented in the baby’s record.