First off, what is a PICC Line?
A PICC or peripherally inserted central catheter is thin tubing inserted into a peripheral vein (vein in the arm or leg) that is guided into a larger vein closer to your heart. This larger vein is located at the top of the heart and is called the superior vena cava and is where the tip of the catheter will rest. The superior vena cava is a short but large in diameter vein which mainly functions as a means to return deoxygenated blood to the heart. The tubing and caps that you see extending out of your arm or leg are called lumens. There can be one or multiple lumens and they function as connectors to administer medications, blood, fluids, etc.
What are the benefits associated with using a PICC line versus a peripheral IV?
Indwelling central catheters allow for safer infusion of medication or supplemental nutrition without the complications that may occur with peripheral IV such as vein irritation or local tissue damage when a toxic drug leaks out of the vein. A wide range of products may safely be given this way. Your PICC line can also be used for hemodialysis, blood draws and for IV feeding administration such as TPN at the discretion of your medical team. PICC lines offer a solution to individuals requiring repeat venous entry for blood draws and prolonged treatment avoiding multiple painful needle sticks and scar tissue build up. PICC lines can be used immediately after placement and will function safely for several months. IV catheters need to be changed every few days and become increasingly difficult to place over time while PICC lines can be left in for several months. Some PICC lines even have specialized tubing that can tolerate higher pressure.
What can I expect on the day of the procedure?
PICC line insertion is a sterile procedure that can be done at the bedside, radiology suite or in some cases the OR. Generally taking less than one hour, you will be expected to lie on your back for most of the procedure. The arm (or leg) chosen will be secured to a board and cleaned. A tourniquet is placed to distend the vein which is selected using an ultrasound. When not done under anesthesia which is mostly reserved for pediatrics, a numbing solution is often applied. After this, you should only feel a pressure sensation.
Using ultrasound for guidance, a thin needle is used to enter the vein and guidewire is inserted through the needle into the vein and the tourniquet is removed. The needle is then removed and the catheter is advanced through the vein over the guidewire into the superior vena cava. The guidewire is removed and your injection cap is attached to the tubing. The catheter is tested for blood return then flushed with normal saline. The insertion site is then cleaned and secured usually with Tegaderm, a clear, adhesive dressing. An x-ray is taken to ensure proper positioning of the catheter tip in the superior vena cava. The external tubing should be measured and recorded for future reference in case of dislodgement concern.
What are my risks associated with PICC line placement?
Infection is always a concern when the skin barrier is broken especially when foreign materials are placed directly into the bloodstream. That being said, an infection caused by the procedure itself is rare due to strict sterile precautions taken. Central line-associated bloodstream infection (CLABSI) is more often caused by poor management of the line after placement. Other risks of the procedure include bleeding which is also minimal as tests are done and precautions taken prior to insertion. Allergic reaction can occur to the anesthetic, prep and flushing solutions and latex. Clotting can happen in the vein around the catheter or at the wall of the vein fairly frequently but rarely significant enough to cause an issue or a delay in treatment. Other risks also rare but worth mentioning include venous thrombosis, pulmonary emboli and breakage of materials such as guidewire or catheters.
How am I going to manage this medical device on my own and minimize my risk for complications?
It is imperative that you follow your care provider’s instructions at home in regards to accessing and flushing your line. Keep the area clean, dry and secure. Use a CareAline PICC sleeve to secure your line. It will minimize dislodgement risk, and protect it from external contaminants and contaminants living on your skin. It will also minimize your risk for tape injury and pulling by almost eliminating the need to use tape on the skin (other than the sterile dressing).
We know first-hand how overwhelming it is when you need extended care that includes a vascular access line, like a PICC. CareAline Sleeves are designed to give you hospital quality care without the hospital feel; providing freedom to move and to do the things that make you YOU.
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