A Peripherally Inserted Central Catheter (PICC) is a long, thin, flexible tube known as a catheter. It is inserted into one of the large veins of the arm above the elbow. It is then slid into the vein until the tip sits in a large vein just above the heart. The PICC line can be used to give you treatments such as chemotherapy, antibiotics, intravenous fluids or feedings. Blood samples can be drawn from the PICC line if blood testing is required. The PICC line allows you to have your intravenous treatments without having needles frequently inserted into your veins. This may be particularly helpful if your veins are hard to find or have been hardened by previous chemotherapy treatment.
PICC Line Installation
Your PICC will be put in by a specially-trained nurse or doctor. First, the skin in the area where the PICC will be inserted cleaned and then numbed using local anesthetic. A needle will be inserted into one of the veins in your upper arm, typically above the elbow. The PICC is then threaded through the vein in your arm into the large vein which leads to your heart called the superior vena cava. The PICC line is then secured to the skin with a dressing. You will then have a chest x-ray to check that the end of the tube is in the correct position. If your veins are small, it may be difficult to put the PICC in. Sometimes it can be difficult to thread the PICC into the appropriate vein in the chest. If this happens, it is possible to try again using a different vein. Care of your PICC line When the line is not being used there is a small risk that it may become blocked or clotted. To stop this happening a small amount of fluid is flushed into the PICC using a syringe. This is typically done regularly, usually once a week. The dressing will also need to be changed regularly to reduce the risk of infection.
Possible Problems
Infection
Any time a medical device, like a PICC line, passes through the skin it is possible for an infection to develop inside or around the device. Because the PICC line enters into a vein it is possible for the infection to spread into the bloodstream. If the area where the PICC line enters the body becomes red, swollen, tender or oozes you should tell doctor immediately. If you have a PICC line and develop a fever or if you feel faint, shivery, breathless or dizzy you should tell your doctor immediately as this may be a sign of a catheter or bloodstream infection. To treat the infection you may be given antibiotics or the PICC line may need to be removed.
Clots
It is possible for a clot (thrombosis) to form in or on the catheter. If enough clot forms around the PICC line the vein in which the PICC line was placed may become blocked or damaged. If this happens, the PICC line may have to be removed. You may be given some medication to help dissolve clots in or around the catheter. Signs of a clot include swelling, tenderness or redness in the arm or neck on the same side of the body as the PICC line.
Damage or Inadvertent Removal of the PICC Line
It is important to be careful with your PICC line to make sure that it is not damaged or pulled out accidentally. Keeping a secure dressing over the PICC line will help prevent it from becoming snagged on things like doorknobs and armrests. If the PICC line becomes damaged or torn contact your doctor. If the PICC line becomes accidentally pulled out call your doctor to get the PICC line replaced or repositioned. If the PICC line is accidentally pulled out there may be some bleeding from the site where the PICC line entered the skin. Hold gentle pressure over the bleeding site for 5-10 minutes and the bleeding should stop. If the bleeding does not stop seek medical attention immediately. If the PICC line has been pulled back but has not been pulled completely out secure the PICC line in place and call your doctor to arrange for replacement or repositioning.
PICC Line Removal
When you no longer need a PICC it will be taken out. A nurse will usually do this for you in an outpatient department. It will be gently pulled out. This is a painless procedure that takes only a few minutes.
