Peripherally Inserted Central Catheter
A peripherally inserted central catheter is a long, thin tube that is inserted through a vein in the arm. The catheter is threaded through the arm vein until it reaches a larger vein close to the heart. This is commonly called a PICC line.
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Reasons for Procedure
PICC lines may be used if you need:
- Long-term medication treatment and cannot take medication by mouth
- Fluids—if you cannot drink enough to stay hydrated
- Calories that you cannot get by eating
- IV medication—if arm veins are hard to find or use
After the PICC line is in, it can be used for weeks to months.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Bloodstream infection —occurs when bacteria enters the bloodstream through or around the central line
- Abnormal heart rhythm —can occur if the catheter tip is out of place and too close to the heart
- Nerve injury—tingling or pain in the arm where the catheter is inserted
- Blood clots
- Air or catheter embolus—air bubble or part of the catheter blocks a blood vessel
Factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
- You may have your blood drawn to check how well your blood clots.
- Your doctor may ask you questions like whether you have any allergies and which arm is dominant.
- Arrange for a ride home after the procedure, as your arm may be numb.
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
You will be given a local anesthetic to numb the area where the PICC line will be inserted.
Description of Procedure
This procedure is usually done in an outpatient setting, so you will not need to stay overnight in the hospital. If you are already in the hospital for a different reason, this procedure is not likely to extend your stay.
Having a catheter inserted increases your risk of a bloodstream infection. The hospital staff will take steps to reduce this risk.
During the procedure, the staff will:
- Give you an anesthetic.
- Extend your arm away from your body.
- Measure the distance from your arm vein to where the catheter will end.
- Cut the catheter to the correct length. Flush the catheter with salt water.
- Place a tourniquet on your arm. A tourniquet is a device used to slow blood flow.
- Make a small incision.
- Insert the catheter into your vein. An ultrasound may be used to help place the catheter.
- Use sutures or tape to secure the PICC line. Place caps on the end of the catheter.
- Cover the insertion site with a bandage. Write the date of the insertion on or near the bandage.
Immediately After Procedure
Your arm will be checked for bleeding, drainage, and bruising.
How Long Will It Take?
About 30 minutes
How Much Will It Hurt?
During the procedure, you will not feel any pain because of the anesthetic. There may be mild discomfort at the insertion site after the procedure.
At the Care Center
Following the procedure, the staff may provide the following care to help you recover:
- Do an x-ray to make sure your catheter is in the correct position.
- Continue to check the insertion site for bleeding.
- Give you medications, fluids, or nutrition through the catheter.
- Flush catheter ports to prevent blood clots.
Take steps to reduce your risk of infection by:
- Thoroughly washing their hands and wearing gloves before touching the catheter or changing the bandage
- Using an antiseptic to clean the catheter opening
- Taking precautions when handling medication, fluid, or nutrition that will be delivered through the catheter
- Watching you closely for signs of infections—These signs include fever, chills, and problems at the insertion site such as redness, swelling, and drainage
- Not allowing visitors in your hospital room when the bandage is being changed
- Keeping the catheter in place only as long as it is needed
There are also steps that you can take to reduce your risk of infection:
- Ask the staff to take every precaution to prevent an infection.
- Tell the staff right away if the bandage needs to be changed or if the site is red or sore.
- Remind everyone entering your hospital room to wash their hands. Do not allow visitors to touch your catheter.
When you return home:
- Do not swim or bathe while your PICC line is in.
- Avoid lifting or any kind of activity that may loosen the PICC line.
- Check the insertion site daily for signs of infection (such as redness or pain).
- Care for the line as instructed by your doctor.
Call Your Doctor
Call your doctor if any of these occur:
- Signs of infection—fever, chills, redness, or swelling at the insertion site
- Pain around the insertion site
- Drainage or leakage from the PICC line
- Trouble flushing or inserting fluids into the PICC line
- PICC line falls out or becomes loose
- Arm grows larger in circumference
If you think you have an emergency, call for emergency medical services right away.
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Central venous catheter. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T146372/Central-venous-catheter. Updated October 25, 2017. Accessed March 2, 2018.
FAQs: Catheter-associated bloodstream infections. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/hai/pdfs/bsi/BSI_tagged.pdf. Accessed March 2, 2018.
6/2/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed March 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 5/11/2013