PICC Line Procedure
Overview
A peripherally inserted central catheter, or PICC line, is a slender tube that healthcare providers place through a vein in the upper arm, extending toward larger veins close to the heart.
While providers usually place it in the arm, use in the leg is very rare. The main reason for using a PICC line is to give treatments such as medications or nutrition directly into the bloodstream.
Key Features of PICC Lines
| Attribute | Description |
|---|---|
| Type | Central venous catheter |
| Placement | Usually arm, rarely leg |
| Uses | Delivering medicine, fluids, nutrition |
| Care Needed | Preventing infection, checking for problems |
A PICC line can reduce the need for repeated needle sticks, making care more comfortable. It also lowers the risk of irritating smaller veins that may not handle frequent IV medicines well.
Careful maintenance helps avoid issues like infections or clots. People with a PICC line learn how to keep it clean and notice any changes. Other central venous access devices, like ports and standard central lines, serve similar purposes but differ in how and where providers place them.
A PICC line starts in a peripheral vein—meaning a vein farther from the center of the body—and is threaded to reach a central vein. This allows medicines and nutrients to spread throughout the body more easily because they are delivered close to the heart.
Reasons for Placement
A PICC line helps people who need treatments that go directly into the bloodstream and must reach the larger veins near the heart. It is especially helpful for patients who need to avoid repeated needle sticks for medicines or blood tests.
Instead of using a new needle each time, healthcare providers can use the PICC line for many types of treatments. Doctors often recommend a PICC line when:
| Situation | Use of a PICC Line |
|---|---|
| Cancer treatment | Delivers chemotherapy or targeted therapy drugs. |
| Nutrition support | Provides total parenteral nutrition (liquid nutrition). |
| Serious infections | Gives antibiotics or antifungal medicines. |
| Irritating medications | Uses larger veins to prevent damage to small veins. |
Some treatments can damage smaller veins because they are very strong or need to be given for a long time. Using a PICC line helps prevent these problems by sending the medicine into a bigger vein, where it mixes with more blood and is less likely to cause injury.
The PICC line can also be used to take blood, perform blood transfusions, or give special fluids before certain scans. Having it in place makes it easier and more comfortable for patients to get the care they need over several days.
Risks
A PICC line can lead to a range of complications. Some concerns include bleeding, nerve damage, and irregular heartbeat. There is also the chance of harm to the veins in the arm, blood clots, infections, or the PICC line becoming blocked or broken.
If issues occur, healthcare providers may treat the problem while keeping the PICC line in place. In more serious cases, they may remove the line. In those situations, another PICC line or a different kind of central venous catheter might be considered.
People should watch for certain symptoms, such as increased redness, swelling, or warmth near the line, a longer section of the catheter sticking out, fever, breathing problems, trouble flushing the line, or changes in heartbeat. Reporting these symptoms to a doctor quickly is important.
Getting Ready Before the Procedure
Patients may need to complete a few steps to be ready for a PICC line insertion. It’s important to share full medical history with the care team. Patients should tell the doctor about past breast surgeries, arm injuries, burns, or radiation therapy.
People with kidney issues or a history of kidney disease should discuss this, since a PICC might not be the best choice for those who may require dialysis later. Doctors often order blood tests to check for healthy platelet levels.
If platelet counts are low, medicine or a transfusion might be needed to lower bleeding risks. Imaging, such as ultrasound or X-ray, helps the healthcare team choose the best insertion site.
What You Can Expect
PICC Line Insertion Process
The person getting a PICC line will usually lie flat with their arm straight out to the side. The skin on the upper arm is cleaned, and a numbing shot is given so the area does not hurt. This makes the procedure more comfortable.
A trained medical provider, often using an ultrasound machine, looks for a healthy vein above the elbow. Sometimes a blood pressure cuff might be placed on the arm to make the veins easier to see. After finding the right vein, the provider makes a small cut to insert a thin, flexible tube called a catheter.
The provider inserts the tube into the vein and gently pushes it up toward the chest. Imaging tools like X-ray machines or ultrasound help confirm the tube’s position. In some cases, a heart monitor may be used to confirm that the tube has reached the right location near the heart.
Once the catheter is in the right place, the provider caps the part that stays outside the body to keep out germs. The end may be taped down for safety so it doesn’t catch or move too much during normal daily activities.
A protective dressing covers the area, keeping it clean. Most patients do not need to stay overnight for this procedure. The numbing medicine usually keeps any discomfort mild.
What to Expect After PICC Line Insertion
After the PICC line is in place, it is normal for the arm to feel a bit sore or tender where the tube enters the skin. This feeling should get better in a few days.
It is important to take good care of the area to prevent infection and keep the PICC line working well. A healthcare provider will show the patient and their caregiver how to care for the PICC line at home. Key points to remember include:
- Protection: Do not lift heavy items with the arm that has the PICC line. Avoid having blood pressure checks on that arm. Do not play rough sports or do anything that could pull on the tube.
- No Water Exposure: The area should not get wet. Cover the line before showers with a waterproof cover. Swimming or using a hot tub should be avoided, since these can make it easier for germs to get in.
- Daily Care: Check the skin around the tube every day for redness, swelling, pain, or oozing. These can be signs of infection. Tell a healthcare provider if any of these signs appear.
- Routine Flushing: The PICC line needs to be flushed with a liquid solution once a week or as instructed. This keeps the tube from clogging and helps with safe use.
- Dressing Changes: The dressing will need to be changed about once a week. The medical team will often do this at the clinic, but they may teach family members how to help at home.
Here is a table with some important do’s and don’ts after a PICC line is placed:
| What to Do | What Not to Do |
|---|---|
| Cover line when bathing. | Do not get the site wet. |
| Check the site for signs of infection. | Don’t lift heavy items. |
| Follow instructions for cleaning. | Don’t play contact sports. |
| Schedule regular dressing changes. | Don’t pull on the tube. |
Some people use PICC line covers to hide the tube day to day or keep it from being bumped. These covers can be bought at a pharmacy or online, or a healthcare provider might provide them.
Having a PICC line means making some changes to daily routines, but most people adjust after learning a few basic care steps. If home care becomes difficult, special nurses and healthcare providers can help out.
This support is especially useful if the patient has trouble seeing or reaching the line, or needs extra help to keep the area clean and safe.
Outcomes
Taking Out the PICC Line
A PICC line stays in place until the end of treatment. When it is time for removal, a healthcare professional slowly and carefully pulls the tube out from the patient’s arm. Removing the PICC line lowers the chance of getting an infection.
Key Points
- A trained doctor or nurse removes the PICC line.
- Removing the PICC line when it’s no longer needed helps lower the risk of infection.
- Sometimes, the line may stay in if there is a high chance another PICC line might be required in the future to avoid harming veins with repeated insertions.
More Information
A PICC line is designed for comfort, durability, and long-term use. It’s soft, flexible tubing stays in place securely, and it may have one to three channels (lumens) to allow multiple therapies at once. These design features support effective treatment while simplifying care for both patients and providers.
