Peripherally Inserted Central Catheter (PICC)

Home Guide

A peripherally inserted central catheter (PICC) is a long, thin, flexible tube that is inserted into a vein in the upper arm. It is a form of intravenous (IV) access. It is considered to be a "central" line because the tip of the PICC ends in a large vein in your chest. This large vein is called the superior vena cava (SVC). The PICC tip ends in the SVC because there is a lot of blood flow in the SVC. This allows medicines and IV fluids to be quickly distributed throughout the body. The PICC is inserted using a sterile technique by a specially trained nurse or physician. After the PICC is inserted, a chest X-ray is done to be sure it is in the correct place.

A PICC may be placed for different reasons, such as:

  • To give medicines and liquid nutrition that can only be given through a central line. Examples are:

  • Certain antibiotic treatments.

  • Chemotherapy.

  • Total parenteral nutrition (TPN).

  • To take frequent blood samples.

  • To give IV fluids and blood products.

  • If there is difficulty placing a peripheral intravenous (PIV) catheter.

If taken care of properly, a PICC can remain in place for several months. A PICC can also allow patients to go home early. Medicine and PICC care can be managed at home by a family member or home healthcare team.

RISKS AND COMPLICATIONS

Possible problems with a PICC can occasionally occur. This may include:

  • A clot (thrombus) forming in or at the tip of the PICC. This can cause the PICC to become clogged. A "clot-busting" medicine called tissue plasminogen activator (tPA) can be inserted into the PICC to help break up the clot.

  • Inflammation of the vein (phlebitis) in which the PICC is placed. Signs of inflammation may include redness, pain at the insertion site, red streaks, or being able to feel a "cord" in the vein where the PICC is located.

  • Infection in the PICC or at the insertion site. Signs of infection may include fever, chills, redness, swelling, or pus drainage from the PICC insertion site.

  • PICC movement (malposition). The PICC tip may migrate from its original position due to excessive physical activity, forceful coughing, sneezing, or vomiting.

  • A break or cut in the PICC. It is important to not use scissors near the PICC.

  • Nerve or tendon irritation or injury during PICC insertion.

HOME CARE INSTRUCTIONS

Activity

  • You may bend your arm and move it freely. If your PICC is near or at the bend of your elbow, avoid activity with repeated motion at the elbow.

  • Avoid lifting heavy objects as instructed by your caregiver.

  • Avoid using a crutch with the arm on the same side as your PICC. You may need to use a walker.

PICC Dressing

  • Keep your PICC bandage (dressing) clean and dry to prevent infection.

  • Ask your caregiver when you may shower. Ask your caregiver to teach you how to wrap the PICC when you do take a shower.

  • Do not bathe, swim, or use hot tubs when you have a PICC.

  • Change the PICC dressing as instructed by your caregiver.

  • Change your PICC dressing if it becomes loose or wet.

General PICC Care

  • Check the PICC insertion site daily for leakage, redness, swelling, or pain.

  • Flush the PICC as directed by your caregiver. Let your caregiver know right away if the PICC is difficult to flush or does not flush. Do not use force to flush the PICC.

  • Do not use a syringe that is less than 10 mLs to flush the PICC.

  • Never pull or tug on the PICC.

  • Avoid blood pressure checks on the arm with the PICC.

  • Keep your PICC identification card with you at all times.

  • Do not take the PICC out yourself. Only a trained clinical professional should remove the PICC.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your PICC is accidently pulled all the way out. If this happens, cover the insertion site with a bandage or gauze dressing. Do not throw the PICC away. Your caregiver will need to inspect it.

  • Your PICC was tugged or pulled and has partially come out. Do not push the PICC back in.

  • There is any type of drainage, redness, or swelling where the PICC enters the skin.

  • You cannot flush the PICC, it is difficult to flush, or the PICC leaks around the insertion site when it is flushed.

  • You hear a "flushing" sound when the PICC is flushed.

  • You have pain, discomfort, or numbness in your arm, shoulder, or jaw on the same side as the PICC .

  • You feel your heart "racing" or skipping beats.

  • You notice a hole or tear in the PICC.

  • You develop chills or a fever.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.