COVIDIEN Argyle™ Peripherally Inserted Central Catheter - Manual (Page 4)

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6. Use lightly heparinized saline to flush the catheter.
7. In order to distend the selected vessel, a tourniquet may be applied.
8. Place fenestrated drape over anticipated puncture site.
9. Puncture the skin approximately 1cm below the proposed access site of the distended vessel with
the introducer. Observe flashback once vein is accessed.
If using “catheter over needle” introducer, remove needle portion prior to inserting PICC into
catheter portion of introducer.
10. Grasp the distal end of the catheter with non-serrated forceps approximately 1cm from the end
and advance the catheter the predetermined distance through the introducer using short, gentle
strokes. (For access via antecubital area, when tip reaches deltoid region, release tourniquet and
turn patient’s head toward access site with chin down to pinch off external jugular vein.)
Note: If catheter meets resistance while being advanced, do not force it. A low pressure flush of
saline may free the tip allowing the catheter to proceed. In the event of vasospasm, apply heat
and proceed according to hospital or institutional protocol.
IMPORTANT CAUTION: AT NO TIME SHOULD THE CATHETER BE WITHDRAWN BACK
THROUGH A SPLITTABLE NEEDLE. IF IT BECOMES IMPOSSIBLE TO ADVANCE THE CATHETER
INTO A SATISFACTORY POSITION, THEN THE NEEDLE AND CATHETER MUST BE WITHDRAWN
SIMULTANEOUSLY. THE RESULT OF WITHDRAWING A CATHETER BACK THROUGH THE
NEEDLE CAN BE CATHETER EMBOLISM.
11. Apply pressure to vein distal to introducer tip to stabilize catheter and carefully withdraw
introducer from puncture site.
Caution: Do not stabilize catheter by applying pressure at point of introducer needle
while withdrawing “splittable needle” introducer – doing so could damage catheter.
12. Apply gentle pressure to insertion site with a gauze pad to stanch blood flow.
13. If using “splittable needle” introducer follow manufacturer’s instructions.
14. If using “catheter over needle” introducer follow manufacturer’s instructions.
15. To achieve proper tip placement after introducer has been removed, non-serrated forceps may be
used to advance the catheter into the venipuncture.
16. Aspirate with a syringe (with heparinized saline) to ensure a good blood return. Flush catheter to
confirm patency.
Note: Do not aspirate blood from the catheter for sampling purposes.
17. Remove drape.
18. If catheter is centrally placed:
a. Temporarily secure catheter.
b. Confirm proper catheter tip placement radiographically.
c. Proper central catheter tip location is within the inferior vena cava or superior vena cava or at
the juncture of the superior vena cava and the right atrium.
Caution: Placing catheter in lower right atrium could cause cardiac penetration and
subsequent pericardial effusion and tamponade.
19. Remove the temporary dressing and prepare the site for final dressing.
Note: Use of skin preps on neonates can cause abrasions or skin sloughing when dressing
is removed.
20. Chart procedure performed noting catheter length. Record whether or not the catheter was
trimmed and to what length.
SECURING THE CATHETER:
The venipuncture site should be protected and the catheter secured with a transparent dressing. Secure
the catheter and dressing to the venipuncture site according to hospital or institutional protocol.
Note: Applying the dressing directly to the catheter can help prevent migration.
Note: Suturing is contraindicated.
Note: Holes located on the stabilizing wing, if present, are intended to be used with Argyle™
catheter securement devices and are not intended for suturing.
Note: Do not use alcohol or acetone based skin preparations, adhesive enhancers, or
solutions directly on the catheter.
Note: Do not apply tape to the catheter.
Recommended Catheter Maintenance:
These recommendations are meant to provide a foundation for developing a protocol for maintaining
the sterility of the catheter and the insertion site, and reducing the chance of the catheter’s accidental
displacement.