Central venous catheterization (PICC) through peripheral vein is a convenient, effective, minimally invasive, safe and less complications catheterization technology, which has the advantages of shallow puncture point, intuition, simple operation, high success rate and long indwelling time. PICC is often used for patients who need long-term intravenous infusion or infusion of drugs with strong irritation and high viscosity, which can effectively protect the peripheral vascular network, reduce patients' repeated puncture and provide patients with medium and long-term care. This technology has been widely used in our hospital and achieved good results. The number of PICC catheters in our department is increasing day by day. Through comprehensive and effective health education, it is of great significance to reduce the occurrence of complications, prolong the service life of catheters and ensure the safety of patients.

Precautions and taboos after catheterization:

1.After PICC puncture, issue a nursing manual to guide them to read it carefully, and inform the patient that the upper limb arm on the catheter side should not be overexerted within 24 hours to avoid bleeding at the puncture point, and appropriate wrist and finger movements can be done to promote blood circulation. If the venous condition is poor or puncture is repeatedly adjusted, wet and hot compress can be applied at the puncture point of 10cm, 3~4 times a day, each time for 10~ 15 minutes, and then hirudoid is applied along the vein to promote the hot compress effect and reduce the occurrence of mechanical phlebitis. After 48 hours, the patient can engage in general daily work, such as sweeping the floor, washing dishes and washing vegetables. , but the scope of activities should be controlled. Don't do shoulder cutting, swimming, table tennis, pull-ups, lifting dumbbells, etc. And the weight of the arm should not exceed a thermos bottle (5 kg). For patients who usually like to play cards, pay attention to the catheter on the puncture side, whether there are folds or creases.

2. Please be careful not to tie a tourniquet, and measure the blood pressure above the arm at the catheter side to prevent the blood from flowing back and blocking the catheter; The cuffs of clothes should not be too tight, especially when wearing clothes in winter, to prevent the catheter from being taken out. Because PICC catheter has exposed connector, it is easy to hook clothes. In order to prevent this phenomenon, clean ladies' heel-less socks or transparent socks can be used to cut off toes and elastic bands, and put them outside the exposed PICC catheter, which can skillfully protect the catheter.

3. During CT and MRI examination, medical staff should be reminded that it is forbidden to use high-pressure injection pump to inject contrast agent into this catheter, which may easily lead to tube explosion and affect normal use. Remind nurses to use 10-20 ml syringe when going to other places or other hospitals for treatment (infusion and maintenance).

4. The catheter is strictly forbidden to contact with sharp instruments and sharp objects to avoid being cut off.

5. Catheter bathing education: the bathing time can be chosen before dressing change and maintenance, because once the dressing change is wet, it can be replaced. It is forbidden to take a bath in the bathtub or bubble bath, and only shower. Before bathing, fully expose the arm on the puncture side, first wrap it with a dry towel at the puncture site, then wrap it with plastic wrap around the puncture point at 10cm for 3-4 times, and then seal the upper and lower edges of the plastic wrap with adhesive tape or rubber band before bathing. Pay attention to uncover the plastic wrap and adhesive tape in time after bathing, and observe whether the film at the puncture site is wet. If there is any abnormality, please go to the hospital to change the film in time to ensure that the puncture site is dry.

6.PICC patients should go to the hospital regularly every week for professional care of catheters (including disinfection, tube flushing, replacement of connectors and dressings). Excessive sweating causes the film to fold and slide, please go to the hospital in time. Do not handle it without authorization (pull out the catheter or send it into the body).

7. If you find the following situations, please go to the hospital in time:

(1) When the transparent dressing is contaminated, curled, wet, etc. , resulting in incomplete catheter shedding.

(2) When itching, rash, redness, pain, secretion, dyskinesia and other abnormal conditions appear at the puncture site and the surrounding skin.

(3) When there are abnormal conditions such as pain, infusion stop and slowness during infusion.

(4) When there is blood reflux in the catheter, the exposed catheter will break, fall off and leak.

(5) The catheter breaks or enters the body,

(6) Edema in the arm on the catheter side or numbness, pain, burning sensation in the chest, and dyspnea.

(7) Eliminate fever caused by other factors.

Because PICC is widely used in clinic, in order to reduce the occurrence of complications during use, we should know the precautions and contraindications, find complications in time and deal with them. Proper nursing can relieve patients' pain, reduce economic waste and protect peripheral blood vessels. Then the pain of patients is alleviated, the work efficiency is improved, and the satisfaction of patients is improved.