- Procedure Overview – Vascular Access
- About Your PICC
- Blood Sampling
- PICC Catheter and Site Care
- Flushing Protocols
- Power Injection for Contrast-Enhanced Scans
- PICC Device Removal
Vascular Access plays a critical role in many patients’ lives, providing medications through reliable access to the central circulatory system. We are continually striving to provide the latest technologies in PICC lines, ports, and locating and accessing veins.
Peripherally Inserted Central Catheters (PICCs)
Your doctor may decide that as part of your treatment, you will need to receive your medications by intravenous injection. Intravenous (IV) injection is the injection of the drug into a vein. If your treatment will need to continue over a period of a few weeks, a PICC may make this possible. A PICC is a special type of catheter, a long, soft, hollow tube that may have one, two or tree openings called lumens, that deliver your medications.
PICCs provide access to the venous system, to allow for the delivery of medication or fluids. Patients who require therapy that will extend over a period of time typically use PICCs. Medical staff insert them, usually into a vein in the upper arm.
Intravenous (IV) injection is the injection of a fluid into a blood vessel that directs blood back to your heart. Insertion of a PICC line makes it possible to receive therapy by intravenous injection over a period of time.
After your skin is numbed and cleaned to remove germs, one end of the catheter is inserted through your skin into the vein. The catheter will be threaded through the vein until the tip of the catheter is near your heart. This is the best place to deliver the required fluids.
Sometimes x-rays are taken as the PICC is inserted. Other times, the catheter is inserted and then an x-ray is taken to make sure the catheter is in the best position.
A dressing will be placed over the area where the catheter comes out of your skin. This is your insertion site, and the dressing protects it.
Some PICCs have a valve designed to keep them closed when not in use, and some do not. In addition, the valve is designed to stay closed during any normal increases in pressure in your veins, which might occur when you laugh or cough.
Sometimes, your health care provider may need to obtain a sample of your blood. Your PICC is used for this purpose. Before obtaining a sample, the PICC should be flushed. The health care provider will then confirm that he or she can draw blood through your PICC by taking a small sample and discarding it.
With a PICC, the healthcare provider will attach a clean needle-less syringe to your catheter and draw up the sample. Before the health care provider is done, they will flush the catheter.
You will need to be care for your PICC line and keep it clean. This includes changing the dressing any time it becomes loose, soiled, or wet and at least one time every week. A healthcare provider, or someone that has been taught how to change the dressing, and has suitable sterile equipment, must do this.
A sterile end cap will be placed on the end of the catheter. This keeps the catheter closed when not in use. Notify your healthcare provider if your end cap(s) becomes loose, comes off, or is leaking. The end caps should be changed often, and your healthcare provider will help you understand this process.
Should I limit my activities while I have a PICC?
Generally, bending your arm, reaching and doing everyday activities will not harm your PICC. You should not lift heavy objects, or carry objects held in the bend of your arm that may put strain on the PICC or the dressing. If your healthcare provider approves, you may take a shower or bath with the PICC in place as long as you cover the PICC and dressing with plastic wrap, a plastic bag or material that will keep it from getting wet. You should NOT attempt other activities, like swimming, that may get the catheter or dressing wet. A wet dressing or catheter may put you at risk for infection.
Notify your healthcare provider or seek medical attention if you have:
- Redness, soreness or swelling at the PICC insertion site or on your arm.
- Fever, chills or vomiting
- Any problems with your catheter while caring for it
- Difficulty giving medications, or being able to draw blood
- A catheter that becomes damaged in any way, leaks or is torn or broken.
Flushing Your PICC Line
For your PICC to work properly, it will need to be flushed occasionally. The flush must be done by a health care provider. A flush occurs when a needle-less syringe filled with saline is injected into your catheter. This forces any remaining medication or blood that may be inside your catheter into the blood stream. Flushing requirements differ depending on which brand of PICC you have.
Under certain circumstances, you may need to receive X-rays, using contrast media via computed tomography (CT) equipment. In a typical procedure, the following steps will occur. You will have this procedure done in radiology. The CT Tech who will administer the procedure will have you lie down on the CT table. They will then prepare you and your PICC line for the procedure.
They will then slide you into the CT system and leave the room. While on the other side of a window, they will administer the procedure. Once completed, they will disconnect the power injection equipment, and flush and dress your catheter.
When your physician feels your PICC is no longer necessary, he will ask that it be removed. Your health care provider will perform this procedure.
Once the catheter is removed, your health care provider will cover the insertion site with a bandage and ask you not to remove it for 24 hour.