A peripherally inserted central catheter (PICC) is a tube which is inserted into one of the veins in the arms and threaded into a larger blood vessel in the chest. This provides care providers with reliable venous access. Patients may be asked to get a PICC line if access will be needed for 30 days or more. Before a peripherally inserted central catheter is placed, the patient will be told why the line needs to be placed, offered alternatives if any are available, and given directions about how to care for the catheter.
A registered nurse or interventional radiologist can place a peripherally inserted central catheter. Before the procedure, medical imaging studies are used to visualize the patient's veins so that the catheter can be reliably inserted. The patient's arm is cleaned with soap and draped with sterile towels to create a clean workspace, and then the PICC line is carefully inserted and moved into position before being sutured in place.
Patients may be offered an anesthetic during the placement, since it can be uncomfortable. It is important to provide the person inserting the peripherally inserted central catheter with feedback about any sensations experienced. If numbness, tingling, and other sensations are felt, it can indicate that the catheter is not placed correctly and it may be pinching a nerve. The catheter's position can be adjusted to address this problem.
Once placed, medications such as antibiotics can be introduced through the tails on the catheter which are left exposed. The catheter can also be used to deliver fluids to the patient. Using a PICC line ensures that health care providers always have venous access and do not need to search for usable veins. It also allows for the delivery of a wide range of needed medications and fluids.
Care directions for a peripherally inserted central catheter include not bathing, swimming, or hot tubbing while the catheter is in, taping the catheter to keep it dry during showers, flushing the catheter to limit clotting, and keeping the tails covered when the catheter is not in use. If the patient experiences pain and swelling, discharge from the area around the catheter, or neurological symptoms such as tingling, they should be reported immediately to a doctor. Likewise, if the PICC line appears to be sliding out, a doctor should be consulted. The line should never be pushed back in because this can cause an infection.
