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Peripherally Inserted Central Catheter (PICC)

A peripherally inserted central catheter (PICC), also called a PICC line, is a long, thin tube that's inserted through a vein in your arm and passed through to the larger veins near your heart. Very rarely, the PICC line may be placed in your leg. This gives your doctor access to the large central veins near the heart. It's generally used to give medications or liquid nutrition. A PICC line can help avoid the pain of frequent needle sticks and reduce the risk of irritation to the smaller veins in your arms. A PICC line requires careful care and monitoring for complications, including infection and blood clots. If you're considering a PICC line, discuss the benefits and risks with your doctor.

Your doctor might recommend a PICC line if your treatment plan requires frequent needle sticks for medicine or blood draws. A PICC line is usually intended to be temporary and might be an option if your treatment is expected to last up to several weeks.

A PICC line is commonly recommended for:

  • Cancer treatments: Medicines that are infused through a vein, such as some chemotherapy and targeted therapy drugs, can be delivered through a PICC line.
  • Liquid nutrition (total parenteral nutrition): If your body can't process nutrients from food because of digestive system problems, you may need a PICC line for receiving liquid nutrition.
  • Infection treatments: Antibiotics and antifungal medicines can be given through a PICC line for serious infections.
  • Other medications: Some medicines can irritate the small veins, and giving these treatments through the PICC line reduces that risk. The larger veins in your chest carry more blood, so the medicines are diluted much faster, reducing the risk of injury to the veins.

Once your PICC line is in place, it can be used for other things, too, such as blood draws, blood transfusions, and receiving contrast material before an imaging test.

This is only one type of catheter used to access the large veins in your chest (central venous catheter). Examples of other types of central venous catheters include implantable ports and central lines.

How to prepare

To prepare for your PICC line insertion, you might have:

  • Blood tests. Your doctor may need to test your blood to make sure you have enough blood-clotting cells (platelets). If you don't have enough platelets, you may have an increased risk of bleeding. Medicine or a blood transfusion can increase the number of platelets in your blood.
  • Imaging tests. Your doctor might recommend imaging tests, such as an X-ray and ultrasound, to create pictures of your veins to plan the procedure.
  • A discussion of your other health conditions. Tell your doctor if you've had breast-removal surgery (mastectomy), as that may affect which arm is used for placing your PICC line. Also let your doctor know about previous arm injuries, serious burns or radiation treatment. A PICC line generally isn't recommended if there's a chance you may one day need dialysis for kidney failure, so let your doctor know if you have a history of kidney disease.

What to expect

The procedure to insert the PICC line takes about an hour and can be done as an outpatient procedure, meaning it won't require a hospital stay. At Sidney Regional Medical Center a specially trained, PICC certified nurse uses imaging technology such as an ultrasound to help guide the procedure. PICC line insertion can be done by a nurse, doctor, or another trained medical provider.

If you're staying in the hospital, the procedure might be done in your hospital room.

Risks

PICC line complications can include:

  • Bleeding
  • Nerve injury
  • Irregular heartbeat
  • Damage to veins in your arm
  • Blood clots
  • Infection
  • A blocked or broken PICC line

Some complications can be treated so that your PICC line can remain in place. Other complications might require removing the PICC line. Depending on your situation, your doctor might recommend placing another PICC line or using a different type of central venous catheter.

Contact your doctor right away if you notice any signs or symptoms of PICC line complications, such as if:

  • The area around your PICC line is increasingly red, swollen, bruised, or warm to the touch
  • You develop a fever or shortness of breath
  • The length of the catheter that sticks out of your arm gets longer
  • You have difficulty flushing your PICC line because it seems to be blocked
  • You notice changes in your heartbeat