Peripherally Inserted Central Catheter (PICC)
A peripherally inserted central catheter (PICC) is inserted into one of the large veins of the upper arm and then advanced until the tip sits in a large vein just above the heart.
The space in the middle of the tube is called the lumen. Sometimes the tube has two or three lumens (known as double or triple lumen). This allows different treatments to be given at the same time.
There will be a small segment of the PICC with a cap on the outside of your body. This is how your infusions will be connected.
Benefits of PICC
A PICC is indicated if your IV therapy will last longer than four days, if you have poor veins and it takes several needle sticks to establish IV access, or if it is difficult to draw blood for lab work.
When cared for properly, your PICC can stay in for weeks, months or years with no problems.
PICCs have fewer complications compared to other central venous access devices.
You can receive many treatments via PICC, such as intravenous fluids, parenteral nutrition, antibiotics, blood transfusions or chemotherapy.
At Golden Valley Memorial Hospital, a PICC certified registered nurse inserts PICCs under ultrasound guidance. The intended insertion site is numbed with a local anesthetic to prevent you from feeling any pain. An alternative will be used if you are allergic to the local anesthetic.
After successful insertion, the PICC is secured and a chest x-ray is performed to confirm correct placement prior to use.
It is not unusual to feel some tenderness at the insertion site a day or two after insertion. Some bruising may occur but will disappear in time.
A PICC should be flushed before and after use or once a week if not being used to maintain patency. We only use preservative-free normal saline for flushing.
The dressing is changed 24 hours after insertion and weekly thereafter. This may be taught to a family member or performed in our Outpatient Treatment Center.
Swimming, hot tubs, heavy lifting and strenuous arm movements are discouraged to prevent complications.
Cover your PICC site with plastic wrap around the arm and secure with tape to protect dressing from getting wet during a bath or shower.
At the end of treatment, upon a physician's order, your PICC will be removed by a trained nurse either while you are in the hospital or as an outpatient in the Outpatient Treatment Center. It is gently pulled out and is usually a painless procedure. The insertion site will have a dressing that can be removed after 24 hours.
Most patients go through their treatment without having any problems with their PICC. However, some potential complications include:
Phlebitis: An irritation inside of the vein wall, which can occur when there is not enough blood flow around the catheter. Less likely to occur with the use of ultrasound to assess vein status prior to insertion.
Infection: Immune-compromised patients have a higher risk of infection. Local and catheter-related blood stream infections are less likely to occur with proper care and maintenance of your line.
Clots (thrombosis): It is possible for a blood clot to form at the tip of the PICC. Once formed, medicine will be given to dissolve the clot and patency can be restored.
Air embolism: Air can enter the blood stream and can cause problems if the end is open. Secure cap at all times. Close clamps (if present) when not in use. Air embolisms are less likely to occur if the line is intact and not open to air.
Split line: This is very unlikely when the PICC is properly cared for. Do not use scissors near the PICC. Not all PICCs can be repaired, and some may have to be removed or replaced.
Contact your physician or call our vascular access nurse if you have concerns about your PICC at 660.890-7269 or call the main line and ask for the house supervisor after hours and weekends.