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CONSENT FOR PLACEMENT OF PICC or MIDLINE Placement of a peripherally inserted central/midline catheter has been ordered by your physician for the following reason(s)(please check) o o o o intravenous

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How to fill out caring for a peripherally

01

Wash your hands thoroughly before handling the peripherally.

02

Gather all the necessary supplies such as sterile gloves, antiseptic solution, and adhesive dressings.

03

Cleanse the insertion site with antiseptic solution using sterile technique.

04

Apply sterile gloves before handling the peripherally.

05

Gently secure the peripherally to the insertion site using adhesive dressings.

06

Monitor the peripherally regularly for signs of infection or complications.

07

Follow any additional guidelines provided by the healthcare professional for caring for the peripherally.

Who needs caring for a peripherally?

01

Individuals who require the administration of intravenous medications or fluids may need caring for a peripherally.

02

Patients who have poor venous access and need frequent blood draws or IV therapies may also require a peripherally.

03

Those undergoing certain medical procedures or surgeries may need temporary peripheral insertion for easy access to veins.

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