posted
My nurse when she changesnthe dressing for me she doesn't wear a mask, and I feel she is carless if the area is clean or not.
Well for the past 4 days, around the site of insertion it been swollen red and very very itchy.
It's getting more swollen each day. I called my nurse and she said it just got irritated from something, it can be from the plastic. We changed to a different dressing and it's still the same.
I am just afraid it's infected
-------------------- Ema Posts: 394 | From Southern California | Registered: Jun 2010
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BoxerMom
Frequent Contributor (1K+ posts)
Member # 25251
posted
Pain, swelling, redness and warmth are signs of infection.
If you have a line infection, this is an emergency. Don't wait for the nurse. Go to the ER.
It could be irritation or allergy. I hope others will respond soon.
posted
I would find a new nurse and have it looked at immediately. For example, it could be MRSA and needs to be evaluated.
Posts: 360 | From Massachusetts | Registered: Dec 2012
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gmb
Unregistered
posted
I agree, get to ER ASAP, you can also request a different home infusion nurse with no questions asked.
How long have you had the PICC? Almost all Lyme patients get a rash from the standard dressing change kit. Ask to change to an "Alcohol/Betadine" dressing kit.
Carol in PA
Frequent Contributor (5K+ posts)
Member # 5338
posted
When is the last time that your nurse looked at the insertion site? If you think that it's getting worse, call her and ask her to come see it and evaluate it again.
Ask her to explain what it would look like if it were infected, and what should you do. Also, check your temperature, as a fever may be a sign of infection.
Sterile technique is important when changing wound dressings. We did not wear masks to change intravenous dressings.
If the nurse pulls out the IV, and the area is inflamed, you can do hot compresses. This will imcrease circulation to the area and promote healing.
Wring out a thick washcloth or a small towel in very warm water, fold and apply to the spot. After a couple minutes, refold the towel to expose a warmer area and apply again. Wring out again in hot water as necessary.
You can do this for 20 to 30 minutes every two hours, or as often as possible. It's tedious to sit holding a hot compress, so have a book handy or watch television.
I have seen inflamed and infected areas heal up quickly by applying hot compresses. It's like a secret weapon!
Posts: 6947 | From Lancaster, PA | Registered: Feb 2004
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desertwind
Frequent Contributor (1K+ posts)
Member # 25256
posted
I developed s PICC line infection from the careless managing of my line from a nurse.
Mine was not on the outside but inside. When I would flush the line I would get a temporary spike in temp. and feel very sick. After a few hours I would feel better again. After a few days if this I got septic and had to go to e.r. Not trying to scare you but don't mess around with this.
My last line flush resulted in a 104 temp. and rigors. Had to get the line removed. If in doubt see your doctor or go to e.r. or a walk in clinic and have them take a look at it.
Posts: 1671 | From Tick Infested New Jersey | Registered: Apr 2010
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posted
The skin can be irritated and inflamed, but what you don't want and what is really serious is an actual infection that gets into the bloodstream.
The skin issues of course should not be ignored, but are not the same as a line infection.
In most cases with a line infection you would suddenly run a high fever as a result of either flushing the line or doing an infusion. If that is what is happening then yes, you need to go to the ER ASAP and the line would most likely be pulled and cultured.
I never wore masks when I changed the dressing on my husband's PICC. I just used alcohol pads to clean the site and large bandaids which I taped in place. Hubby did not have his lines stitched in place as he had a reaction to the stitches. A stat lock was used instead. And he had to try a couple of different tapes to find one that did not irritate him.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
Nurse and patient should wear a mask when changing PICC or Port dressings. This is a recommendation from the Infusion Nurse Society Guidelines. These are the guidelines that all the hospitals and reputable healthcare institutions follow.
I would recommend that you go to the hospital to have your PICC site evaluated and to have blood cultures drawn just to be safe. Blood infections are very serious life threatening events.
It's best to get treatment as soon as you can once they identify what is going on. At the hospital they will have an expert IV team that will better be able to help you.
They can try different dressings and cleansers to see what is best for you also. This is during or after you've been treated for infection.
So please go to the ER. This is beyond the scope of your home care nurse. She is obviously incompetent.
Posts: 5237 | From here | Registered: Nov 2007
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But in the interest of not getting too panicked, I did have a LOT of itchiness with my line and surrounding area. It turns out I'm kind of sensitive to medical adhesives, and whatever dressing they used, I'd itch like crazy, and my arm was red and irritated.
Every time I've gotten a line pulled (I've had 5 placed), I still end up wearing longsleeves for a few weeks, because the skin looked so terrible.
So it's possible that it's just irritated, and nothing to worry about, but you should always get those things checked if you're worried.
Posts: 306 | From Brownsville, PA | Registered: Jul 2007
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I didn't end up going to the ER. I had the nurse come and check on it again.
She told me it could be a possible infections, but she said let's wait and see if it will get any worse.
She is said it's most likely my skin is very sensitive to the material. So, she removed the dressing and changed it to another type of plastic to see if the swelling will go down.
-------------------- Ema Posts: 394 | From Southern California | Registered: Jun 2010
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posted
This is the second time she changed it to a different dressing and we are waiting to see if the swelling will go down.
I have no idea if I have fevers as i tend to get hot flashes a lot. I guess I should check it.
-------------------- Ema Posts: 394 | From Southern California | Registered: Jun 2010
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Carol in PA
Frequent Contributor (5K+ posts)
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posted
You can get a decent oral digital thermometer for five to ten dollars. I bought a cheap one 25 years ago, and it still works fine.
Posts: 6947 | From Lancaster, PA | Registered: Feb 2004
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-------------------- Ema Posts: 394 | From Southern California | Registered: Jun 2010
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
When she cleans the site make sure that she doesn't push the PICC in or pull it out, that can irritate the site and make it painful too. Also if she pushes it in she will push germs in from your skin which will cause infection in your blood later on!
Also, are there stitches at the site to hold the PICC in place? They can become infected too. Signs would be redness warmth and pain and sometimes crusty drainage. You may also get a Fever.
If you have a fever you really should go to the ER or at least be seen by a doctor, catheter infections are bloodstream infections that can be life threatening. These are things that your nurse should be aware of. So not trying to scare you, just being realistic here. I've seen people get very sick from this.
Just go to CVS or Walmart, anywhere will have a cheap digital oral thermometer. They work well.
Worth the couple dollars to keep around the house for times like this.
Posts: 5237 | From here | Registered: Nov 2007
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Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
Yes, please go to the ER if this is still going on.
If it's skin irritation, as others have said, you will need to try different dressings and cleansers to see what you tolerate best. When it's really bad, you can (with a good nurse's help) have the
dressing removed, and for a few days use sterile cotton dressings wrapped around your arm, which need to be changed
every 2 or 3 days (I forget which). IV 3000 Hand is a good hypoallergenic dressing to try after that.
DO NOT keep the same blasted nurse who didn't wear a mask!! This can put your life at risk! You need a new nurse!
Ask your infusion company to send a nurse who ALWAYS follows every aspect of sterile and clean technique. Your life depends on it! And ask them to also send you a copy ASAP of all the
guidelines that should be followed (if they haven't already). Read it, and make sure that every nurse follows it to a T. If they don't, demand that they do, and demand a better nurse the next time.
Sadly, sloppy nurses are common, and you cannot afford to allow it. I've raised a ruckus about it many, many times. You shouldn't have to, but we do need to.
Posts: 3771 | From around | Registered: Mar 2008
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The swelling went down a bit. It's still itchy and looks like it's bruised. Also i do have this crusty discharge that is around the insertion side.
I dont have a fever while im infusing. So, not sure if it still can be an infection.
I really hate going to the ER, im usually very stubborn when it comes to that, and i probably shouldn't be
-------------------- Ema Posts: 394 | From Southern California | Registered: Jun 2010
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Razzle
Frequent Contributor (1K+ posts)
Member # 30398
posted
Crusty discharge can be from infection.
But I'm glad it seems to be improving. Keep a close eye on it. And DEMAND that the nurse use full sterile procedure with every dressing change! It is your body and you have a right to be treated properly!
-------------------- -Razzle Lyme IgM IGeneX Pos. 18+++, 23-25+, 30++, 31+, 34++, 39 IND, 83-93 IND; IgG IGeneX Neg. 30+, 39 IND; Mayo/CDC Pos. IgM 23+, 39+; IgG Mayo/CDC Neg. band 41+; Bart. (clinical dx; Fry Labs neg. for all coinfections), sx >30 yrs. Posts: 4166 | From WA | Registered: Feb 2011
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posted
The skin issue can be helped by using skin prep after your skin in cleaned, it is a barrier to help protect your skin. I had some issues at insertion site as first nurse pushed my picc in further so that the part the is larger diameter was in my arm. By watching it and cleaning it over time, it got better.
If you are concerned can your LLMD order blood work or send you for an ultrasound on your picc line to be safe instead of an ER visit?
I agree you should request a new nurse from infusion company. I didn't think things were right and spoke up but wish I had done so sooner.
Posts: 120 | From MA | Registered: May 2010
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Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
quote:Originally posted by trimom: I had some issues at insertion site as first nurse pushed my picc in further so that the part the is larger diameter was in my arm. By watching it and cleaning it over time, it got better.
OMG, this is NOT something that anyone should ever do, or you should ever allow: pushing the line in further, that is. This is absolutely not sterile and puts you at risk of sepsis!!
Posts: 3771 | From around | Registered: Mar 2008
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