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Peripherally inserted central catheter - insertion

What Is a Peripherally Inserted Central Catheter (PICC)?

A PICC is a long, thin tube (called a catheter) that goes into a vein in your upper arm. The end of the catheter winds up in 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 procedure is done in the radiology (x-ray) department or at your hospital bedside.

  • 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.
  • 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 doctor if you develop a fever.

It is OK to take showers and baths 7 to 10 days after your catheter is placed. When you do, 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 Call the Doctor

Call your doctor or nurse 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 doctor if your catheter:

  • Is coming out of your vein
  • Seems blocked

References

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

Infusion Nurses Society. Infusion Nursing: Standards of Practice; Revised 2011. J Infus Nurs. 2011;34(1S):S37-S48.

Updated: 2/7/2014

John A. Daller, MD, PhD., Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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