Peripherally Inserted Central Catheter
|Veins in the Arm|
|Copyright © Nucleus Medical Media, Inc.|
Reasons for Procedure
- 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
- 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
- Arm veins that are hard to find due to obesity or poor blood flow
- History of blood clots
- Broken arm
- Active infection
- Lymph nodes removed from the arm
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. Medications stopped may include:
- Anti-inflammatory drugs, such as ibuprofen
- Blood thinners
- Anti-platelet medications
Description of Procedure
- 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
How Long Will It Take?
How Much Will It Hurt?
- Do an x-ray to make sure your catheter is in the correct position.
- Continue to check the insertion site for bleeding.
- Give you medicines, 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 medicine, 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
- 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.
- Keep your insertion site clean, dry, and covered with a bandage. Follow your doctor's instructions for changing the bandage.
- Before touching the catheter, wash your hands or use a hand sanitizer. Wear gloves when touching the area.
- If allowed by your doctor, cover the bandage with plastic when showering.
- Do not swim or bathe while your PICC line is in.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Avoid lifting or any kind of activity that may loosen the PICC line.
- Do not allow anyone to touch the catheter or the tube.
- Check the insertion site daily for signs of infection (such as redness or pain).
- Learn how to take care of your catheter .
- Flush the line with saline or heparin as directed.
- Take medicine as directed.
Call Your Doctor
- 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
American Academy of Family Physicians http://familydoctor.org
American Cancer Society http://cancer.org
The College of Family Physicians of Canada http://www.cfpc.ca
Health Canada http://www.hc-sc.gc.ca
Caring for your peripherally inserted central catheter. Cystic Fibrosis website. Available at: http://www.cff.org/UploadedFiles/treatments/Therapies/Respiratory/PICC/PICC%20Fact%20Sheet.pdf. Published 2006. Accessed July 8, 2013.
Central venous catheter. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 8, 2013. Accessed July 8, 2013.
FAQs: Catheter-associated bloodstream infections. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hai/pdfs/bsi/BSI%5Ftagged.pdf. Accessed July 8, 2013.
6/3/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: 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.e8.
- Reviewer: Marcin Chwistek, MD; Michael Woods, MD
- Review Date: 07/2013 -
- Update Date: 05/11/2013 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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