3M PICC dressing change

[@hellaSwankkyToo]

thank you for this! i’ve watched this video numerous times to help ease the anxiety i feel every time i have to change my own PICC line dressing. 😣😩 it’s been very helpful. thanks again! 🖤✊🏾

[@hellaSwankkyToo]

2 QUESTIONS re: BIOPATCH→ *1. what’s the correct direction for placement of the BIOPATCH?* [10:28] [this part wasn’t visible in the video.] i know which side goes up + which side goes on the skin//PICC site, but which direction should the opening//split face? up toward my chin or down toward the line (my PICC is in my chest)? and…. *2. what do you mean by, “do not wrap the BIOPATCH around a PICC line, place the BIOPATCH around the CVC?”* [10:50] i assumed the slit was so that the line could go through the BIOPATCH + make full contact w| my skin//insertion site? 😳 incorrect? i’ve noticed each nurse does this part differently + that when the BIOPATCH is not placed _around_ the line just on top, the BIOPATCH inevitably moves, starting a day or 2 after the dressing change. in the video, the nurse says, not to wrap it around the PICC line, wrap it around the CVC - *what’s the CVC if not the PICC line?* 😬 of course i plan to ask the next few nurses i see. however, i fully expect to get a different answer from each one, as that’s what’s been happening since i got my line . LOL 🤷🏾‍♀️ [eg. when one of my lumens cracked, i was told to just be extra careful; next couple of nurses just avoided it + used the other lumen. but when an ER nurse found out it was cracked, she + the doctor looked mortified + _immediately_ scheduled me for a replacement w| IR, citing serious danger//increased risk of infection. they were stunned anyone let me leave the hospital, let alone walk around w| a cracked lumen + the IR co-signed their concern. so, i really don’t know what to think//believe. 🤷🏾‍♀️] if anyone does happen to see this + respond - thank you in advance! 🖤✊🏾

[@rachellepadgett1858]

I have always placed the biopatch split in the direction of the line + statlock + extension tubing (if that makes sense). So when you're removing the old dressing, especially like they demonstrated here, the biopatch will not get stuck and snag the line while trying to remove the old dressing. So in this example, I'd place the biopatch split facing at a 6 o'clock direction. =)

[@rachellepadgett1858]

Also, not sure about the cracked lumen, but don't think it's related to the biopatch. The biopatch should fit perfectly around the line at the insertion site, it can 'connnect' but it doesn't, and the line anchors it in place. The biopatch should not move around under the dressing. Definitely agree that the line should've been replaced though, if cracks were seen, not only for risks of infection but also for risk of embolism. A nurse should alert the physcian and or vascular access team of the impaired condition, as we'd need an order before just pulling it =) Hope this helps, and I hope you're therapy is going well (without any complications).

[@micahandme8078]

When you remove a PICC dressing, you should secure the catheter by pressing on the exposed line. Keep moving up the line as the dressing is being removed- even if a Stat-lock or wing guard is in place to assure migration does not occur. Whenever you are touching a PICC line, always make certain you remove the finger that is securing the line very slowly. One of the easiest and most common way to migration is from any glue sticking to your glove. As far as having an assistent: in 17 years in nursing, I have never seen staffing levels where 2 RN's are able to perform a CVAD dressing change. As an infusion RN, it is possible to keep a sterile field while stabilizing a midline, PICC, or port without migration. You should also clean beneath the visible portion of the exposed catheter that lies beneath the dressing. That is the most likely area that fosters bacterial growth due to the fact it takes longer to dry, and therefore may rem;ain moist while the dressing is in place. The protocol in infusion nursing is to allow chloro-prep to dry for 3 minutes. If not completely dry, the chloro-prep will likely cause an intense itchy rash which can develop into blisters in very little time. My last tip; if it itches, complete a dressing change with 3 alcohol swabs, followed by betadine, and skin prep. In the event your patient continues to have an itchy rash, you may have to change the dressing again, in which case the skin prep will help to avoid irritation to the skin from all the adhesive pulling the top layer of epidermis off. Hope that helps.

[@moox1195]

I'm secretly hoping that you would do a video! these are great tips

[@christi8488]

Thanks

[@ritaparker231]

Good idea to use the piece of sterile tape provided in the kit to secure the picc lumen/s so they are not dangling or pulling before you remove the dressing and securement device. The instructions come inside the PICC dressing kit the ones we use . Thanks for posting the video!!

[@rachellepadgett1858]

This is one of the better examples of PICC dressing changes I've seen on here. I agree that having an extra set of helping hands is random and not normally possible. But that aside, you could have done this using your techniques and only one set of hands while staying sterile. The extra hand actually shouldn't have touch the insertion site after you cleaned it, with the 'dirty' gloved finger. Overall good demonstration.

[@crappysockpuppet]

After observing there are a few things that need to be addressed. You put the patient' mask on and then the nurse put her mask on without washing her hands in between. When placing dressing supplies on the open prep kit you went directly over your sterile field on the table that you set up on. The proper technique is to have the assistant open the 3m dressing and the person who is sterile remove it from its packaging. Both nurses were observed placing sterile gloves over jewelry and their watches. This can cause tears in the sterile gloves and cause contamination to their sterile field. I observed breaks in sterile technique with the person who was applying the dressing touching the end of the catheter tip. Not trying to be critical but these are very important steps to preventing a CLABSI.

[@papergirl1416]

The very first thing the nurse did was touched the underside of the table that she had not cleaned to move it closer to the patient thus contaminating her hands and did not rewash her hands before touching the sterile picc line dressing kit. Was this video not reviewed prior to posting?

[@olisaprice9870]

Fantastic Video

[@chongkiriggen3789]

The lady in graphic scrubs waved her hand on top of the sterile field and she also turned her back on the sterile field.

[@christinewhelan6181]

So many things wrong with this !

[@autumnmeadows4079]

Why are you using sterile gloves to remove the dressing? Sure it is great that you have extra sterile gloves, but you can use clean gloves. I like how you use the gauze to hold, but sometimes this is not available. Yes, I agree that the hair should be tied back. What do you do when you are by yourself and need to secure the line? No statlock?Otherwise, I did like some of this. So thank you.

[@sassyinscrubs5206]

This is a wonderful video but it would have been really helpful to have the camera actually looking at the pic line instead of at a group of people. You can't actually see what they're doing

[@stepangolobyn1625]

Hi. Why food prep people have to use hair net, but nurses doing sterile procedure are not??????

[@angelahughes5783]

In the OR environment, we do have to have our hair covered by a surgical head covering. We are also not supposed to wear earrings, necklaces, or anything that dangles and could contaminate. In addition, we wear freshly laundered jackets when opening and passing sterile supplies to prevent the potential of our skin shedding onto sterile areas. So, this video is just showing you the basic how to. Keep up that critical thinking!

[@jeffreybowers1220]

i had to get a picc line when i was recovering after a coma in the hospital. i had no idea what it was or how they do it. i was terrified. but getting it and taking it out was painless.

[@tonadia2]

This is the 4th video I'm watching on central line dressing changes and the previous 3 had significant errors in them. I appreciate you making a thorough video that shows the correct procedure. I personally didn't see any sterile field issues. Thank you for taking the time to make this video to help me see the process.

[@Clamplow]

tomasik there are several errors here to... She has long hair that comes over her shoulders, a wristwatch! No apron, manicured nails, (with what looks like nail polish) and a ring

[@mariemwanyali3562]

Why the client wear mask?

[@shahjahanaararafiqahmed613]

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[@bettysmith4527]

@@mariemwanyali3562 It is a sterile procedure, and if the patient talks, sneezes, coughs etc that would easily contaminated the site since it is close to the face.

[@hellaSwankkyToo]

TBH, i’ve never had a nurse use anything to help remove the dressing. they always just start yanking it off, which is so stressful to watch 🫣 - having to trust someone else to do it w|o accidentally yanking out my line, especially before i had it replaced + it wasn’t sutured//secure at all. even more anxiety-inducing, i let a nursing student do it once + while the change was successful, they ended up putting on the needle-free connector too tight, cracking the part of the lumen that couldn’t be changed w|o replacing the entire line. which….is exactly what ended up happening. 😣 learned quite a few things from this video, including that i can use something to help remove the old dressing w|o causing a tangled mess + stressing me out + that gloves need to be changed during the process.

[@jbsantos17]

If only we can have another nurse to lend her finger to hold the line in real life. In real life u doing this shit alone lmaoo.

[@hellaSwankkyToo]

right! i wish. LOL even worse if you are the patient + doing your own dressing change - an extra set of hands would be so clutch!

[@samanthacobley1405]

Don't really see the point in the masks if you are going to wear a wrist watch, don't have hair tied back or wear an apron

[@patriciaready-olson602]

Samantha Cobley of

[@annamedina9866]

I know right??? WTF??? These half assed “ nurses “ aren’t fukin nurses at all!!! They don’t even care about or keep sterility in mind!! WHY would they make a video??!!?? These are the nurses that Medi%Cal patients get.... Nuff said.... FUKIN D Students.....

[@gianellisumas4600]

The mask is there for a very good reason I would know bc I have had a picc like done not to long ago and the mask are there so there isn't any bacteria or anything they just want more protection

[@notatrollll]

anna medina jesus christ, calm down

[@etm567]

Why am I under the impression that you should wash your wrists as well as your hands?

[@mcraemctaggart4396]

The watch should have been removed as it harbours bacteria beneath it.

[@MarfaEugene]

So do you really need 2 people to dress picc.

[@sapphire912]

What about changing the clave?

[@peterbrown1968]

yes i had a picc line in my arm it was a pain in the bum. I had leukaemia 2 years ago im good today if I don't get it back

[@peterbrown1968]

@The Beautiful One thank you

[@FnFrk]

EVL?

[@hazelcastro7059]

Love it!! I'm watching it from Honduras.

[@raquelochoa1016]

DO NOT shake hands after wash only dry

[@riittaseppala1306]

You have wach also!!??

[@debraarnold875]

Perhaps we’d have less bacteria if she was professional enough to get her hair up and out of the way

[@mygorgeousmedia]

I had a PICC Line before. I'm a hard stick due to my Sickle Cell

[@rosangelamesquita7047]

Oi

[@med3484]

Not even close to sterile...

[@ladygeez6180]

😂😂😂😂

[@Elcooper6969]

i had this done last year .its was so uncomfortable having this tube inside me for 2 weeks

[@kaylacorrine4139]

J Nolastname I’ve never noticed mine. In all honesty, I found it so much easier to shower with rather than having a peripheral IV because those usually end up having to be placed in my AC (where your elbow bends.) With the midline, I could move my arms freely and it was a plus that the IV wasn’t beeping every ten minutes when I would bend my arm causing an occlusion in the line.

[@Jamie_Winsh]

The helper should not be touching the insertion site. When cleaning she keeps coming back to the insertion site, risking germs to get into body. Also ridiculous amount of gloves and hilariously over protective

[@michelebouvet8074]

You did not wash between your fingers, waving your non gloved hands all over the sterile field, you picked up a non sterile pack of etoh with your sterile gloves, using your steile glove which are now not sterile to touch the inside of the dressing. Folks, this is not at all what to do. Do not follow this example. I can't watch the rest....it's painful.

[@0524laicheung]

Good show Cheryl Jones

[@riittaseppala1306]

This not ok. Where is this desinfektio with handalcohol? And Your clothes for work?

[@Mossy1201]

Too far and i cant actually see/watch it close.

[@akilkhankhan4292]

Nice way

[@francesroberts2652]

started off wrong . Bare below the elbow for washing of hands.

[@noebarajas9577]

Beautiful my favorite girls 🇲🇽 😍😊😘

[@patrickjohnson1285]

Hi... who is the nurse in the grey scrubs?

[@patrickjohnson1285]

I just noticed the U.K. Jacket

[@lakinpellon666]

Me too...trying to see if they work @ UK

[@connieoriley2516]

Very excellent demo!!

[@SharpLife4]

Why would the patient where a mask as well I've seen it done where you ask the patient to look away and no breath on it. Of course for kids and such its different.

[@betsykemp1902]

Sharp life, standards of care recommend you have the patient wear a mask but it is not required. I have my patients wear them if they want to watch what I am doing. It is also protection for it you have the patient look away and they decide to look at what you are doing. It helps avoid them contaminating the area.

[@meenik6489]

As a patient it's always good to know sterile protocol and watch the change to make sure all goes like it's supposed to. Nurses are humans too and humans make mistakes. You can't breath on the picc so that's one reason for why patients wear masks

[@georgemcgovern1389]

Tegaderm

[@liliabaucero7438]

Traducir al español.

[@mitzikatib6759]

Why don't you put your hair up in a bun you should not have your hair down and cut your nails while you're at it

[@Lovebug-ut8mx]

This is so very wrong

[@mitzikatib6759]

Ridiculous your hair is all over girl put it up at least you're wearing scrubs

[@iason3230]

Я не говорю на вашем языке. Почему не носите шапки ?....?. Что вы там делаете? За что вам там платят деньги? Вы только пиздите и не делаете ничего?