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Tweezer Use for PICC Line Placement

I was taught to use tweezers for advancing the PICC/Midline catheter though the introducer. My problem is, one of our PICC kits doesn't come with tweezers and sometimes it almost impossible to advance with just tweezers. I was wondering what other PICC teams where doing? Does everyone use tweezers or do they use sterile, powder-free gloves to advance their PICC's? What does the INS recommend?

Wendy Erickson RN
We were initially trained to

We were initially trained to use the tweezers too in the kits to advance the catheter. For many years now, though, we have been using our gloved fingers (powder free). It took some time to get used to it and not feel like we were doing something wrong, but you get a good sense of ease of threading, the "feel" of obstructions, etc.

Wendy Erickson RN
Eau Claire WI

Chris Cavanaugh
Tweezers prevents talc phlebitis

The use of tweezers was commonly taught when sterile gloves contained talc. Now that most if not all are talc free, this is not as necessary. The idea was to avoid the risk of talc phlebitis when handling the PICC. Some PICC lines also come with a protective sleeve, a barrier that peels off as the line is placed through the introducer, allowing even gloves with talc to hold the catheter and feel the subtle changes as it is advanced. This is another option to consider instead of using tweezers.

Chris Cavanaugh, RN, BSN, CRNI, VA-BC

Actually, the issue of

Actually, the issue of particulate matter goes back to the original PICCs. Silicone has a very high negative electrical charge which attracts all particulate matter such as talc, towel lint, air-borne particles, etc. The very first PICC ever made was black, which displayed these particles very well. So it was changed to a white silicone so we could not see those particles. I have never used forceps for PICC insertion and always thought it was a time-consuming, tedious procedure that took away my tactile sense for meeting obstructions. In the beginning, we placed the PICC in a base of sterile water and actually washed the talc off of sterile gloves. Now there is a lesser need for this because we have powder-free gloves and polyurethane PICCs.

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Infection rate

Have you noticed any difference in infection rate being higher for advancing PICC lines with sterile gloves instead of tweezers. 

Infection rate

Thanks Lynn for your response...   I agree, it is easier to feel any resistance advancing the catheter with sterile gloves instead of tweezers, but does this technique increase the risk of infection?  Should I change my gloves before touching the catheter in case my gloves touched the patients prepped skin while holding the ultrasound? 

Don't touch the skin with

Don't touch the skin with sterile gloves even though it is already prepped. If you accidentally touch it, change your sterile gloves before touching the catheter.

So are you saying to change

So are you saying to change sterile gloves after placing introducer? Since the skin is touched when removing needle & inserting introducer.



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