What is Peripherally Inserted Central Catheter (PICC)?

A PICC line, or Peripherally Inserted Central Catheter, is a thin, flexible tube inserted into a vein in the upper arm and threaded into a large vein near the heart, such as the superior or inferior vena cava. It is used to administer medications, fluids, blood products, and nutrients directly into the bloodstream over an extended period.

Additionally, it serves for blood withdrawal when necessary. Unlike a standard intravenous (IV) line, a central line, including a PICC line, is notably longer and extends up to a vein near or within the heart. PICC lines are often utilized for patients who require frequent or long-term intravenous treatments, such as chemotherapy, antibiotic therapy, or parenteral nutrition. They offer a more comfortable and convenient alternative to traditional intravenous catheters, reducing the need for repeated needle sticks. Trained healthcare professionals insert them, requiring regular care and maintenance to prevent complications.

Why use a PICC Line instead of a regular Intravenous (IV) line?

A PICC line is preferred over a regular intravenous (IV) line for several reasons:

1. Long-Term Access: PICC lines are suitable for patients who require long-term or frequent intravenous treatments, such as chemotherapy, antibiotic therapy, or parenteral nutrition.

2. Reduced Discomfort: PICC lines offer a more comfortable alternative to traditional IV lines as they can be left in place for an extended period, reducing the need for repeated needle sticks.

3. Convenient Administration: PICC lines allow for the administration of medications, fluids, blood products, and nutrients directly into the bloodstream without the need for frequent needle insertions.

4. Access to Larger Veins: PICC lines are inserted into more prominent veins in the upper arm and threaded to a central vein near the heart, providing better access to administering medications and fluids.

5. Lower Risk of Complications: Compared to other central lines, PICC lines have a lower risk of infection, clot formation, and damage to blood vessels, making them a safer option for long-term use.

6. Prolonged Duration: A PICC line can remain in place for up to 3 months or longer, minimizing the need for frequent replacements.

What happens during the PICC line administration?

Healthcare providers typically insert PICC lines in specialized settings like operating rooms, intensive care units, or interventional radiology suites. The process involves:

1. Sedation: Patients receive sedation or general anaesthesia to ensure comfort and minimize pain during the procedure.

2. Preparation: The healthcare provider cleans and numbs the skin at the insertion site, usually in a vein near the arm bend.

3. Insertion: Using ultrasound guidance, the PICC line is carefully inserted into the vein and threaded to a large vein near the heart.

4. Verification: The PICC line placement is confirmed via X-ray to ensure proper positioning.

5. Dressing: Once confirmed, a dressing or bandage is applied over the PICC line insertion site.

The insertion procedure typically takes approximately 15–20 minutes to complete.

Risks associated with the PICC line?

Complications associated with PICC lines may include:

1. Bleeding

2. Nerve injury

3. Irregular heartbeat

4. Damage to arm veins

5. Blood clots

6. Infection

7. Blocked or broken PICC line

While some complications can be managed to retain the PICC line, others may require removal. Depending on the circumstances, your doctor may recommend replacing the PICC line or using an alternative central venous catheter.

It's crucial to contact your doctor promptly if you experience any signs or symptoms of PICC line complications, such as:

• Increasing redness, swelling, bruising, or warmth around the PICC line site
• Fever or shortness of breath
• Lengthening of the exposed catheter
• Difficulty flushing the PICC line due to a suspected blockage
• Changes in heartbeat