PICC management for bladder tumor patient with toxic epidermal necrolysis: A crisis intervention case report

Abstract

Crisis intervention is crucial in managing acute medical crises to improve outcomes. Toxic Epidermal Necrolysis (TEN), a severe skin reaction often triggered by drug exposure, poses challenges, especially in chemotherapy patients. Evidence on nursing care for TEN patients with Peripherally Inserted Central Catheter (PICC) retention during chemotherapy is limited. We present a 69-year-old male with recurrent bladder tumor receiving atezolizumab via PICC, developing TEN and catheter-associated skin impairment (CASI). Despite extensive skin breakdown, PICC retention was essential and innovative PICC care was necessary. A crisis management team implemented a six-step crisis intervention model, ensuring safety and treatment adherence. A three-layer dressing protocol was used to optimize wound care, prevent further CASI, and ensure the patient’s comfort. This case underscores the efficacy of crisis intervention in managing TEN with PICC during chemotherapy, highlighting interdisciplinary collaboration and innovation in complex medical scenarios.