PICC stands for Peripheral Inserted Central Catheter. A PICC line is a soft, small, long, hollow tube that is placed into a vein in your upper arm just above the bend of your elbow. The PICC line travels up through the vein inside your arm into a larger vein just above your heart. A PICC line is a long-term use access to your vein that can be used to give chemotherapy, medications, nutrition, and to draw blood for lab work.
A PICC line can be placed either as an in-patient or out-patient procedure. It is often placed at the bedside by a nurse who specializes in placing central lines. A sterile field is used to prevent infection. A numbing medication is put into your arm using a small needle. The nurse will use an ultrasound machine to see your vein. A small cut will be made and then the PICC line will be placed into your arm. The insertion site is covered by a dressing. You will have one or two lumens (tubes) dangling from the insertion site which will either be sutured in or a device like a sticker will be used to keep it in place.
The lumens are short, small tubes with caps at the end. The lumens are used to give medications or draw blood. When your provider uses these lumens it is sometimes called “accessing the PICC line”. Once your PICC line is in, an X-Ray will be ordered to make sure it is in the right place.
If you have a history of blood clots or a PICC nurse is not able to place a PICC line you may have your PICC placed in the interventional radiology department. Your PICC will be placed in the same way but it is done under fluoroscopy and x-ray so that your vein is better visualized.
There are usually no problems when you have a PICC line placed. But, there is the risk of air embolism, phlebitis, blood clot, nerve irritation, and injury and irritation to the heart muscles resulting in an arrhythmia. A central line is a direct portal into your veins. The most common complications of central lines are infection and a clot in the catheter(occlusion). Occlusion is a blockage in your line, which makes the catheter unusable and can interrupt your treatment. A medication may be used to break up the clot.
Each day you should look at your central line to check for any changes to the dressing, the insertion site, and the lumens. Make sure your dressing is intact and not wet or dirty. Signs and symptoms of infection may be seen at the insertion site and include redness, swelling, drainage, bruising, and bleeding.
- Hands should be washed by anyone touching or accessing the PICC line. Before touching the PICC line hands should be washed and gloves put on. After touching the PICC line gloves should be removed and hands once again washed.
- A dressing will be put over the PICC line insertion area. This keeps the area clean and helps keep the PICC line from coming out. The dressing should be changed at least once a week, or if it becomes wet or dirty. Place a plastic cover or sleeve over your PICC line while bathing. Never use scissors to cut away a dressing.
- The PICC line must be flushed on a regular basis to prevent it from becoming occluded. Flushing entails attaching a syringe filled with normal saline solution and putting the fluid into the PICC line through the lumen. With some PICC lines, a medication called heparin is also used which prevents clotting. Usually, the PICC line needs to be flushed each day.
- Check your PICC line each day to watch for signs of infection and loosening or contamination of the dressing.
- Do not pull on the PICC line. Take care to secure the lumens against your skin to prevent pulling out your PICC line.
- When your PICC line is no longer needed, it may be removed by your provider in the office.
Your care team will show you or a family member how to change the dressing or flush the line if it is necessary for this to be done when you are at home.
When to contact your care team
Daily monitoring of your PICC line is needed so that you become aware of any changes to your PICC line. If you notice any redness, pain, discharge, or swelling at the site of insertion contact your provider immediately. You also want to contact your provider if flushing of the line is hard, the lumens become cut or break, you have any pain with use of the PICC line or the PICC line has become dislodged from your arm.
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