Vascular access device (PICC line insertion)
What is a PICC?
It is a long plastic tube (catheter) which is put into one of the large veins in your arm over the elbow joint. The tube then passes through the large veins of the arm and shoulder and the tip of the tube is positioned in the big vein above the heart, this vein is called the superior vena cava. The PICC line is put in by a doctor.
Why am I being offered a PICC?
The PICC can be used to give you treatments such as chemotherapy and antibiotics. It can also be used to take samples of your blood for testing. You can go home with the PICC and it can be left in for weeks or months. This makes it possible for you to have your treatment without having to have needles frequently inserted into your veins. This may be particularly helpful if your veins are hard to find or have been hardened by previous treatments.
How is the PICC put in?
Inserting a PICC is a minor procedure. A local anaesthetic is used so you should not feel pain. The doctor putting in the PICC will wear a sterile gown and be assisted by a nurse. They will select a suitable vein and put a needle into that vein. The PICC will then be threaded through the needle into the vein and then up into the correct position. The needle then can be removed leaving the PICC in the correct position. This positioning is done under image guidance; ultrasound and X-ray.
To minimise bleeding after the insertion of a PICC restrict arm movement for the first two hours. A pressure bandage will be applied for the first 24 hours.
Who will look after my PICC?
The PICC is held in place with an adhesive waterproof dressing. The dressing will need changing weekly, or more often if it becomes loose or soiled. If the PICC is not being used for continuous infusion then it will need flushing with a solution by a nurse to ensure the line does not block (heparin).
Can I have a bath or shower?
Yes, you may shower as you wish as the dressing is shower proof. When having a bath, do not submerge the dressing in the bath. If you have a pump attached to your PICC it must not get wet. If showering, put the pump into a plastic bag hung above the shower.
Are there any problems with PICCS?
Complications with PICCs are not common. However, you should be aware of them before you consent to having one. There are two serious potential risks:
- Thrombosis—this is a blood clot that forms around the PICC. This can occur anywhere along the PICC. If it happens in the vein of the arm, then the arm will become painful and the hand and arm may swell up. If it happens in the veins of the chest, then you may notice a dull ache deep in the shoulder that comes on gradually and does not go away.
- Infection—whenever a cannula or PICC is put into a vein it is always possible for a ‘germ’ to go through the PICC. The symptoms could include: feeling unwell; feeling cold, followed by shivering; redness, tenderness and /or discharge around the PICC entry site; a high temperature—above 38° C.
If you experience either of these two symptoms you need to talk to someone from the contact list immediately for further direction.
Other complications that may occur include:
- Mechanical phlebitis—this usually occurs within the first few days of the PICC line insertion. It is soreness and inflammation of the arm veins due to the line rubbing the delicate lining of the vein. It should settle down after a few days. It can be alleviated by applying a warm moist compress to the affected area for several minutes, 3–4 times per day.
- Line movement—this can occasionally occur. The external length of your PICC will be noted in your hospital record. If it is noted that your line has moved more than 2cm then you will require an X-ray of the PICC to check that it is still in a correct position.
- Blocked PICC—Despite the best care, a PICC can still become blocked. If it is unable to be cleared by the nurses then it will need removing.
- Damaged PICC—It is important that the PICC line is not cut, split or broken. If it does get damaged then immediately refer to contact numbers listed.
Location and contact details
Mater Private CardioVascular Unit
Mater Private Hospital Brisbane
Level 6, 301 Vulture Street, South Brisbane,
Telephone: 07 3163 6700
Bookings: 07 3163 1146 or 07 3163 1147
Facsimilie: 07 3163 6720
Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: HOSP-005-00771
Last modified 13/11/2015.