TESTS AND PROCEDURES

Peripherally Inserted Central Catheter (PICC)

October 07, 2017

Peripherally Inserted Central Catheter (PICC)

Outline of human figure with catheter inserted into right arm at elbow. Two ports are at end of catheter. Catheter can be seen going up arm vein into heart.

You need a peripherally inserted central catheter (PICC) for your treatment. A catheter is a small, soft tube. The catheter is inserted into a vein in your arm. It is then moved through your vein until the tip sits in the large vein (vena cava) near your heart. A PICC is often used when treatment requires you to have medicine or nutrition for weeks or months. When you no longer need the PICC, your healthcare provider will remove it. Your skin will then heal. This article tells you more about a PICC and how a healthcare provider places it in your body.

Why do I need a PICC?

A PICC takes the place of a standard IV (intravenous) line. A standard IV needs to be changed every few days. Since the PICC can stay in place longer, you may have fewer needle sticks during your treatment. There is less damage to the small veins where an IV would normally be inserted. Your healthcare provider can give you more details about why you need the PICC.

Getting a PICC

A short procedure is done to place the PICC in your body. This will be done in your hospital room, the radiology department, or somewhere else in the hospital. It may vary slightly from the steps described here. Your healthcare team can tell you what to expect. In general, during PICC placement:

  • You’re fully covered with a large sterile sheet (drape). This lowers risk for infection. Only the spot where the PICC will be placed is exposed. The skin here is cleaned with an antiseptic solution.

  • Ultrasound images may be viewed on a video screen. These are used to help find the best vein to use.

  • The area where the PICC will be inserted is numbed with a shot of local anesthetic. This decreases discomfort during the PICC placement.

  • After the local anesthetic takes effect, the catheter is gently passed into the vein. It’s moved along until the tip is in the vena cava, close to the heart.

  • The other end of the catheter sticks out a few inches from your skin. It may be loosely attached to the skin with stitches (sutures) or a securement device.

  • The provider will flush the catheter with saline solution, to clear it. The solution may include heparin, which prevents blood clots.

  • An X-ray or other imaging test is done. This confirms the catheter’s position and checks for problems.

Risks and complications

As with any procedure, getting a PICC has certain risks. These include:

  • Infection

  • Bleeding problems

  • An irregular heartbeat

  • Injury to the vein or to lymph ducts near the vein

  • Inflammation of the vein (phlebitis)

  • Clots or air bubbles in the bloodstream

  • Blockage of the blood vessel where the catheter is inserted

  • Clots in the vein that may travel to the lung (pulmonary embolism)

  • Nerve injury

  • Accidental insertion into an artery instead of a vein

  • Catheter not positioned correctly

Updated:  

October 07, 2017

Sources:  

Central Venous Catheter Care for the Patient With Cancer: American Society of Clinical Oncology Clinical Practice Guideline. Journal of Clinical Oncology. Schiffer. 2013., Complications of central venous catheters and their prevention. UpToDate., Overview of central venous access. UpToDate.

Reviewed By:  

Image reviewed by StayWell medical illustration team.,Mancini, Mary, MD,Ziegler, Olivia, MS, PA