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Peripherally inserted central catheter - insertion

Alternative Names

PICC - insertion

What is a Peripherally Inserted Central Catheter (PICC)?

A PICC is a long, thin tube (called a catheter) that goes into your body through a vein in your upper arm. The end of this catheter goes into a large vein near your heart.

The PICC helps carry nutrients and medicines into your body. It is also used to draw blood when you need to have blood tests.

A PICC is used when you need intravenous (IV) medical treatment over a long period of time or if blood draws done the regular way have become difficult.

How is a PICC Inserted?

The PICC insertion procedure is done in the radiology (x-ray) department or at your hospital bedside. The steps to insert it are:

  • You lie on your back.
  • A tourniquet (strap) is tied around your arm near your shoulder.
  • Ultrasound pictures are used to choose the vein and guide the needle into your vein. Ultrasound looks inside your body with a device that is moved over your skin. It is painless.
  • The area where the needle is inserted is cleaned.
  • You get a shot of medicine to numb your skin. This may sting for a moment.
  • A needle is inserted, then a guide wire and the catheter. The guide wire and catheter are moved through your vein to the proper spot.
  • During this process, the needle puncture site is made a little larger with a scalpel. One or two stitches close it up afterward. This does not hurt.

The catheter that was inserted is connected to another catheter that stays outside your body. You will receive medicines and other fluids through this catheter.

After the Catheter is Placed

It is normal to have a little pain or swelling around the site for 2 or 3 weeks after the catheter is put in place. Take it easy. DO NOT lift anything with that arm or do strenuous activity for about 2 weeks.

Take your temperature at the same time each day and write it down. Call your health care provider if you develop a fever.

It is usually OK to take showers and baths several days after your catheter is placed. Ask your provider how long to wait. When you do shower or bathe, make sure the dressings are secure and your catheter site stays dry. DO NOT let the catheter site go under water if you are soaking in a bathtub.

Other Care

Your nurse will teach you how to take care of your catheter in order to keep it working correctly and to help protect yourself from infection. This includes flushing the catheter, changing the dressing, and giving yourself medicines.

After some practice, taking care of your catheter gets easier. It is best to have a friend, family member, caregiver, or nurse help you.

Your doctor will give you a prescription for the supplies you need. You can buy these at a medical supply store. It will help to know the name of your catheter and what company makes it. Write this information down and keep it handy.

When to Contact a Medical Professional

Call your health care provider if you have:

  • Bleeding, redness, or swelling at the catheter site
  • Dizziness
  • Fever or chills
  • Hard time breathing
  • Leaking from the catheter, or the catheter is cut or cracked
  • Pain or swelling near the catheter site, or in your neck, face, chest, or arm
  • Trouble flushing your catheter or changing your dressing

Also call your provider if your catheter:

  • Is coming out of your vein
  • Seems blocked

References

Herring W. Recognizing the correct placement of lines and tubes and their potential complications: critical care radiology. In: Herring W, ed. Learning Radiology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 11.

Hughes JA, Cantwell CP, Waybill PN. Peripherally inserted central catheters and nontunneled central venous catheters. In: Mauro MA, Murphy KPJ, Thomson KR, et al., eds. Image-Guided Interventions. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 118.

Intravascular therapy. Springhouse, ed. Best Practices: Evidenced-based Nursing Procedures. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007:chap 4.

Mansour JC, Neiderhuber JE. Establishing and maintaining vascular access. In: Neiderhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 26.

Review Date:11/1/2015
Reviewed By:Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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