Which step is described as part of the PICC removal sequence regarding sutures and withdrawal?

• A. Remove any sutures, gently withdraw catheter, and have patient perform Valsalva as the last 5-10 cm.
• B. Rinse the catheter with saline before removal.
• C. Withdraw the catheter rapidly without guidance.
• D. Leave the catheter in place temporarily.

Answer: (A)

When removing a PICC, the steps are arranged to prevent air from entering the bloodstream and to minimize tissue trauma. First, any securing sutures are removed so the catheter can move freely without tugging at the insertion site. Then the catheter is withdrawn gently to avoid tissue injury. As the catheter exits, the patient performs a Valsalva maneuver during the last 5–10 cm of withdrawal. This brief bearing-down action increases intrathoracic pressure and helps seal the venous entry, reducing the risk of an air embolism as the catheter is removed. Rinsing with saline beforehand isn’t a standard removal step and doesn’t address embolism risk. Removing rapidly or leaving the catheter in place temporarily would increase complications or defeat the purpose of removal.