- PICC Line 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 line 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 are used to deliver your medications.
PICC lines provide access to the venous system, to allow for the delivery of medication or fluids. PICCs are typically used for patients who require therapy that will extend over a period of time. They are usually inserted 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 makes it possible to receive therapy by intravenous injection over a period of time.
After your skin has been cleaned to remove germs and numbed, one end of the catheter will be 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 called your insertion site, and the dressing will protect 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 or port can be used for this purpose. Before obtaining a sample, the PICC or port should be flushed. The health care provider will then confirm that he or she can draw blood through your PICC or port by taking a small sample and discarding it.
With a PICC, the healthcare provider will attach a clean syringe to your catheter and draw up the sample. With a port, the healthcare provider will first gain access to your port using a needle, and then draw up the sample with a clean syringe. Before the health care provider is done, he or she will flush the catheter.
Your PICC line will need to be cared for and kept clean. This includes changing the dressing any time it becomes loose, soiled, or wet and at least one time every week. This can be done by a healthcare provider, by you, a family member, or friend that has been taught how the dressing is changed.
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 line?
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 line or 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 do 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, is torn or broken.
Flushing Your Peripherally Inserted Central Catheter (PICC)
For your PICC to work properly, it will need to be flushed occasionally. A flush occurs when a 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 line you have. The flush can be done by a health care provider, or another individual that has been taught how to do this.
Flushing Your Implantable Port
Each time you receive a treatment, the skin over your port should be cleaned by your nurse. A small, special needle is inserted through both your skin and the septum, the self-sealing silicone rubber area in the center of the port.
After the needle is in place, the nurse will first inject a saline solution to flush your port. Then, you will receive the fluid that contains your medication. From the port chamber, the fluid flows through the catheter into your bloodstream.
After your medication has been delivered, the nurse will flush your port with saline again and remove the needle. A small bandage may be placed over the port area.
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, he/she will administer the procedure. Once completed, the power injection equipment will be disconnected, and your catheter will be flushed and dressed.
When your physician feels your PICC is no longer necessary, he will ask that it be removed. This procedure will be done by your health care provider.
Once the catheter is removed, your health care provider will then cover the insertion site with a bandage and ask that you do not remove it for 24 hours.