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What is a PICC Line?

If you have recently been asked to use a PICC line or may have any questions about it, this blog will help you better understand the uses, alternatives, benefits and risks associated with a PICC Line.

What is a PICC Line?

A peripherally inserted central catheter is a long, soft, thin, and flexible tube that is inserted in a peripheral vein in the arm. This line is then guided to a larger vein that eventually leads to the heart. The insertable portion of the PICC varies between 25 to 60 centimeters.

What is a PICC Line Used For?

A PICC line is typically used to provide long term treatment to a patient directly to the large vein near the heart. The most common use cases include providing:

  • Peripheral (PPN) or total parenteral nutrition (TPN) for those that need to supplement or replace their nutritional requirements.
  • Intravenous antibiotics and antifungal medicines to fight a serious infection
  • Other medications that tend to irritate small veins in the body
  • The giving or taking frequent blood and blood products

How Long Can a PICC Line Stay In?

A PICC line can stay in your system for up to a year. The duration of time depends upon the length of treatment, which typically ranges from weeks to months and is at the discretion of the treating physician.

Central Line vs PICC Line 

A central line, also known as CVC (central venous catheter), is placed in the neck, chest, or groin. A central line gets its name because the tip ends in the largest vein of the body. It is longer, with a larger tube which allows concentrated solutions to be infused with less risk of complications. A PICC is typically placed in the upper arm, with its tip ending in the largest vein in the body, the vena cava. 

PICC Line Benefits

  • Reduces the number of needles inserted for IVs
  • Mitigates the discomfort from the many needle sticks that are required of patients for continual medications and blood draws.
  • Prevents irritation in veins and blood vessels caused by IV medication
  • Can be used to obtain most blood tests
  • Can remain in place for weeks and months for patients that are in a hospital setting, nursing facility, or at home

PICC Line Risks

Common risks of PICC Line include:

  • Discomfort may be experienced during the procedure
  • Bleeding may occur at the site of insertion
  • Embolus – this can be either an air embolus (bubble of air within the bloodstream) or equipment embolus if the catheter or piece of equipment breaks
  • Although it is a rare occurrence, there is a chance for accidental puncture of an artery, nerve, or tendon can occur near the insertion site. Leakage can occur due to skin elasticity, outward line migration, or line rupture
  • Multiple attempts may need to be made for PICC insertion causing pain or irritation
  • Infection may occur at the insertion site or in the bloodstream
  • PICC line malfunction from the line getting clogged. Medications are available to clear the line, but may not always work leading to PICC line removal. 
  • Partial or complete removal of the PICC  if not well-secured and completely covered. The use of a PICC Line Cover can help prevent this from happening.

Rarer more infrequently occurring risks include:

  • tamponade, secondary to vessel wall damage
  • atrial or ventricular perforation
  • bacteremia, septicemia, arrhythmias
  • there is a chance for accidental puncture of an artery, nerve, or tendon can occur near the insertion site. Leakage can occur due to skin elasticity, outward line migration, or line rupture

PICC Line Cover

A PICC line cover is a sleeve, generally made of fabric that is worn over the PICC’s medical dressing. The cover provides coverage and protection to prevent pulling and/or displacement of the PICC. The cover allows patients to securely cover their PICC lines and helps conceal it in a dignified fashion.

PICC Line Alternatives

The TIVAD (totally implantable vascular access device) is a long hollow tube that is inserted into one of the large veins in the body. TIVADS are also called Ports or Portacaths. Another PICC line alternative is the Tunneled CVC (central venous catheter). A CVC is a long flexible tube that is generally inserted in the vein below the collarbone. 

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