OET letter with a PICC line, cannula or drain: how to write device care
If the OET Nursing case notes include a line, cannula or drain that stays in after discharge or transfer, say what device it is, where it is, when it was inserted and what it is for. Then give the care the notes ask the reader to provide, such as flushing, dressing changes or measuring drainage, and the signs they must report. Devices that were removed before discharge usually need only a short mention, or none.
Why devices need care in OET letters
Case notes for surgical and infection patients often mention several devices: a cannula, a urinary catheter, a wound drain, a central line or a PICC line. Some are removed during the stay; one may remain when the patient leaves. The reader needs to know about the device that stays, because they will look after it.
A good rule: the device that remains gets a clear sentence; devices that were removed and caused no problem are left out. Catheters have their own guide: see catheter and continence letters.
Questions to answer before you write
- Which devices are still in place at discharge or transfer?
- Where is each one, and when was it inserted?
- Why is it there (antibiotics, nutrition, drainage)?
- What care do the notes say it needs, and how often?
- What signs must the reader report?
- When is it due to come out, and who removes it?
What to include and what to leave out
| Usually include | Usually leave out |
|---|---|
| Device still in place, site and insertion date | Cannulas removed without problems |
| Purpose of the device | Insertion procedure details |
| Care routine from the notes (flushes, dressings) | Brand names and gauge sizes, unless relevant |
| Drain output trend and latest figure | Every output chart entry |
| Signs to report (redness, swelling, fever, leakage) | Normal daily site checks |
| Planned removal date or review | Ward routines |
Turning device notes into sentences
| Notes | Letter sentence |
|---|---|
| PICC R arm inserted 4/9 for IV abx | "A PICC line was inserted in his right arm on 4 September so that he can receive intravenous antibiotics." |
| Flush weekly, dressing change weekly | "The line needs to be flushed and the dressing changed once a week." |
| Wound drain in situ, output ↓ 20 mL/24 h | "A wound drain remains in place, and drainage has reduced to about 20 mL a day." |
| Cannula L hand removed d2, site red → resolved | Usually leave out. |
| Report pain, swelling, fever | "Please contact the team if he develops pain or swelling in the arm, or a fever." |
| Drain removal at surgical clinic 15/9 | "The drain will be removed at the surgical clinic on 15 September." |
All figures and dates here are invented. In the test, copy the care instructions exactly as the case notes give them. For more on numbers, see vital signs and test results in letters.
Keep device care in one place
The most common problem is scattering: the PICC line appears in paragraph two, the flushing schedule in paragraph four, and the warning signs in the closing request. The reader then has to hunt for the instructions. Instead, group them:
- What the device is, where, and why.
- The care routine.
- What to report.
- When it comes out.
This is part of organisation and layout as well as content.
Worked example (invented case)
Case summary (invented): Ms Priya Okonedo, 52, office manager, lives with partner. Admitted 1 September with a severe leg infection (cellulitis) after a garden injury. IV antibiotics on ward; PICC line inserted left arm 3 September to continue IV antibiotics at home for 10 more days (home infusion arranged). Line needs flushing after each dose; dressing change weekly. Peripheral cannula removed. Leg redness reduced, leg to be kept raised. Temperature normal for 48 h. Report fever, arm swelling or pain, redness at line site. Line to be removed by community team after final dose. Likes running. Discharge 8 September. Task: write to the community nurse.
Selection decisions:
- In: infection and its cause, PICC site, date and purpose, antibiotic duration, flushing and dressing plan, warning signs, removal plan, leg elevation.
- Out: removed cannula, running, office job, daily temperatures.
Sample letter body:
Dear Community Nurse,
Re: Ms Priya Okonedo, aged 52
I am writing to refer Ms Okonedo, who is being discharged home today to complete a course of intravenous antibiotics for a leg infection.
Ms Okonedo was admitted on 1 September with cellulitis of the leg following a minor injury in her garden. The redness has reduced, her temperature has been normal for two days, and she has been advised to keep her leg raised.
A PICC line was inserted in her left arm on 3 September so that she can continue intravenous antibiotics at home for a further ten days, and home infusion has been arranged. The line needs to be flushed after each dose and the dressing changed weekly. It should be removed after her final dose.
I would be grateful if you could care for her PICC line, remove it once the course is complete, and contact us if she develops a fever, redness at the line site, or pain or swelling in her arm. Please do not hesitate to contact me if you require any further information.
Yours sincerely,
The removed cannula is left out, and all the line care sits in one paragraph. The warning signs appear once, in the request, where the reader will act on them.
Practise timed letters at /writing/, or check a letter you have written to see which case notes you included, missed or added unnecessarily.
Mistakes to avoid
- Listing every device used on the ward. Only the ones still in place, or with a problem, matter.
- Unexplained abbreviations. Write PICC, CVC or IDC in full the first time.
- Copying drain charts. Give the trend and the latest figure.
- Missing the removal plan. The reader needs to know who removes the device and when.
- Scattering instructions. Keep the device, its care and the warning signs together.
Related: infection and antibiotic letters, post-operative discharge letters and wound care letters.
Sources
This guide is medEmu's writing advice, not official OET guidance or clinical advice; all patients, devices, figures and plans are invented for practice and must not be used to guide care. The network used for this run could not reach oet.com, so no OET test facts are stated beyond the criterion names. For OET's official Writing information, see oet.com.