Peripheral Inserted Central Catheter (PICC System)

Innovative long-term IV therapy, the PICC system, is particularly beneficial for individuals facing complex health challenges: patients requiring prolonged treatments (chronic illnesses, chemotherapy, long-term antibiotic therapy), individuals with damaged veins, children undergoing extended therapies, and those receiving therapy at home.

The PICC system offers an efficient and comfortable way to administer long-term intravenous therapy. A painless and less invasive alternative, the PICC system provides stable access to veins, reducing the need for frequent painful needle insertions and the risk of irritation to smaller veins on the hands.

A Peripherally Inserted Central Catheter (PICC) is a long, thin tube inserted through a vein in the arm and threaded through larger veins near the heart. Very rarely, it can be placed in the leg.

Advantages of the PICC System:

1. Long-lasting access: PICC lines provide long-lasting access to the bloodstream. Unlike IV injections that involve repeated needle punctures, a PICC line can remain in place for weeks and months, reducing the need for frequent needle insertions.
2. Reduced pain and discomfort: PICC lines are less painful compared to repeated IV injections, especially when the patient requires frequent infusions or blood draws. Once the PICC line is in place, medical staff can easily access veins without additional discomfort for the patient.
3. Administration of various medications: PICC lines allow the administration of different medications, including chemotherapy, antibiotics, and other infusions, over an extended period. This versatility is particularly useful for patients requiring continuous or prolonged treatments.
4. Reduced risk of vein irritation: IV injections can cause irritation to smaller veins in the hands, leading to phlebitis or thrombophlebitis. PICC lines are placed in larger central veins, reducing the risk of irritation and potential damage to smaller peripheral veins.
5. Safe medication administration: PICC lines are usually placed in larger veins near the heart, providing a stable access point for rapidly diluting medications into the bloodstream. This stability can be crucial for the efficient and safe administration of certain medications.
6. Suitable for home care: PICC lines can be used for home care, allowing patients to receive necessary treatments at home.
7. Reduced frequency of needle insertions: PICC lines eliminate the need for frequent needle insertions, reducing vein trauma over time. This is particularly useful for patients with difficult-to-access veins or those prone to complications from repeated needle insertions.
8. Lower risk of extravasation: Extravasation occurs when drugs administered through an IV line leak into surrounding tissues, potentially causing harm. Properly placed and maintained PICC lines can reduce the risk of extravasation compared to peripheral IV lines.
9. Blood draws without needle insertions: PICC lines provide a convenient and less painful way for frequent blood draws. Medical staff can easily draw blood samples from the central vein accessed via the PICC line, avoiding the need for additional needle insertions.

Who Needs the PICC System?

A Peripherally Inserted Central Catheter (PICC) is necessary for various medical reasons, and its application is determined by the specific treatment plan requirements of the patient. It is particularly useful in the following situations:

Long-term medication administration: PICC lines are often used when patients require prolonged administration of medications (chemotherapy, long-term antibiotic therapy).

Frequent blood tests: A PICC line can provide a practical and less painful way for regular blood draws without the need for repeated needle insertions.

Chemotherapy: PICC lines facilitate medication administration and provide a more stable and accessible route for the direct delivery of chemotherapy into central veins near the heart.

Total Parenteral Nutrition (TPN): When individuals cannot obtain sufficient nutrients through the digestive system, PICC lines can be used to deliver total parenteral nutrition, a complete liquid nutrition solution.

Intravenous Antibiotics: Serious infections that require prolonged treatments with intravenous antibiotics can be treated using a PICC line, which enables efficient delivery of medications directly into the bloodstream.

Reducing Vein Irritation: Some medications may cause irritation to smaller veins in the hands. The use of a PICC line allows these medications to be administered in larger veins in the chest, reducing the risk of irritation and potential damage to smaller veins.

Extended Hospital Stays or Home Care: PICC lines are often employed when a patient requires an extended period of intravenous therapy, whether in a hospital or at home. They provide a more practical and less invasive option compared to traditional IV lines.

Versatility for Various Procedures: Once inserted, a PICC line can be utilized for various medical procedures, including blood transfusions, the administration of contrast material before imaging, and other interventions that require access to the bloodstream.

How to Prepare for the Placement of the PICC System?

Preparing for the placement of the Peripherally Inserted Central Catheter (PICC system) involves several steps to ensure the safety and success of the procedure. Here are some guidelines:

• Talk to your doctor about the reasons for installing the PICC system, the planned course of therapy, and the benefits you can expect. Ask questions about the procedure, potential risks, and the steps to be taken during and after the placement of the PICC line.
• The doctor will likely prescribe certain tests, such as blood tests, X-rays, or ultrasound, to assess your health condition and choose the appropriate type of PICC system.
• Inform your doctor about all medications, including supplements, that you are currently taking. The doctor may recommend discontinuing certain medications that could affect blood clotting.
• On the day before the PICC line placement, take a thorough bath. Do not use creams, lotions, or deodorants on the day of placement, especially at the site where the PICC line will be inserted.
• The doctor may recommend not eating or drinking for a few hours before the PICC line placement, especially if the procedure will be performed under anesthesia.
• If the procedure is done under anesthesia or if you expect discomfort, consider having a family member or friend accompany you.

Procedure for Placing the PICC System:

1. Preparation:

• The patient will be asked to change into a medical gown.
• The doctor will review the patient’s medical history and confirm the purpose of placing the PICC system.

2. Local anesthesia:

• The insertion site will be sterilized.
• Local anesthesia will be applied to the site where the catheter will be inserted to reduce discomfort during the procedure.

3. Catheter insertion:

• Ultrasound or X-ray imaging will be used to identify the appropriate vein for placing the PICC line.
• The needle will be inserted through the skin and guided into the vein, and then the catheter will be advanced through the needle.

4. Confirmation of position:

• After placing the catheter, X-rays or other images will be used to confirm that the PICC line is correctly positioned.

5. Securing the PICC line:

• After confirming the position, the PICC line will be secured using special dressings or tapes.

6. Completion of the procedure:

• The insertion site will be covered with a sterile dressing for protection and to prevent infection.
• The patient will be monitored after the placement of the PICC system.

7. Patient education:

• The patient will receive information on caring for and maintaining the PICC line at home, including regular flushing and changing dressings.

How Long Does the PICC System Placement Procedure Take?

The procedure for placing the PICC system usually takes about one hour, but the exact time may vary depending on various factors, including the experience of the medical staff, the anatomical complexity of the patient, and the need for additional procedures or imaging for accurate positioning of the PICC line.

How long does a peripherally inserted central catheter (PICC) last?

The duration during which a peripherally inserted central catheter (PICC) remains in place varies and depends on the specific medical needs of the patient and the treatment plan. PICC lines are commonly used for usage that can last from two to six weeks, and sometimes even several months.

Are PICC lines safe?

Peripherally Inserted Central Catheters (PICC lines) are generally considered safe when properly placed, maintained, and monitored. However, as with any medical procedure, there are potential risks and complications associated with PICC lines:

• Infection: Infections can occur at the insertion site. It is crucial to maintain strict hygiene practices during the placement procedure and in the routine maintenance of the PICC line.
• Blood clots: There is a risk of blood clot formation around the PICC line. This risk may be higher in certain medical conditions or with prolonged use of the PICC line.
• Irritation or damage to veins: The PICC line may cause irritation or damage to the vein into which it is inserted, although this is a rare occurrence.
• Rupture or blockage of the catheter: The catheter may rupture or become blocked, requiring intervention.
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It is essential to follow appropriate protocols and guidelines to minimize these risks:

1. Regular flushing: Regularly flushing the PICC line with a sterile solution helps prevent blockages and ensures proper functioning.
2. Wound care: Proper wound care is important to prevent infections at the insertion site.
3. Monitoring for complications: Healthcare professionals should respond to signs of any complications, such as redness, swelling, or signs of infection.

Seek medical attention if you notice any signs or symptoms of complications related to the PICC line, such as:

• The area around your PICC line becoming increasingly red, swollen, bruised, or warm to the touch.
• Fever or difficulty breathing.
• The length of the catheter appearing longer.
• Difficulty flushing the PICC line as it seems to be blocked.
• Changes in heart rhythm.

How do daily activities look like with a PICC system?

1. Protection and Care: It is essential to protect the PICC line to prevent accidental pulling or contamination. Patients are advised to avoid activities that may pose a risk to the line, such as lifting heavy objects or participating in rough sports. Regular care includes cleaning the site where the line is placed, monitoring signs of infection, and flushing the line according to the doctor’s instructions.

2. Showering requires special precautions to protect the insertion site and prevent infection:

– Use a waterproof cover or dressing to cover the PICC line and secure it in place. These protections are designed to keep the insertion site dry during showering.

– Prolonged exposure to water in baths, pools, or hot tubs should be avoided unless your doctor provides specific instructions to the contrary.

– When washing the skin around the PICC line, use a mild, unscented soap and avoid rubbing the area. After showering, gently pat the insertion site dry with a clean, soft towel.

– After showering, inspect the PICC line insertion site for signs of damage, such as a loose dressing or redness. If you notice anything unusual, contact your doctor.

– Check that the dressing covering the PICC line is securely in place before showering. If the dressing becomes wet or loose, follow the doctor’s or nurse’s guidelines on whether it needs to be replaced.

3. Sleeping: Prioritize your comfort. If the PICC line is on the side where you want to sleep, you may need to adjust your sleeping position to avoid direct pressure on the insertion site.

Placing a pillow between your arm and body or under your arm can provide support and help reduce pressure on the PICC line. Try different pillow positions to find the one that suits you best.

4. Clothing Choices: Wearing loose-fitting clothing, especially during sleep, can help prevent friction or irritation around the PICC line insertion site.

How long does a peripherally inserted central catheter (PICC) last?

The duration during which a peripherally inserted central catheter (PICC) can remain in place varies and depends on the specific medical needs of the patient and the treatment plan. PICC lines are most commonly used for applications that can last from two to six weeks, and sometimes even several months.

Procedure for removing the PICC system:

The removal of a peripherally inserted central catheter (PICC system) is usually performed in a relatively straightforward manner. Here is a general description of the procedure:

1. Preparation:

Before the procedure begins, the medical staff will prepare all necessary materials, including gloves, sterile gauze, and, if needed, local anesthetic.

2. Local anesthesia (if necessary):

If required, local anesthesia may be applied to the site where the PICC line will be removed to reduce discomfort.

3. Removal of adhesive tape or bandage:

Adhesive tapes or bands securing the PICC line will be carefully removed.

4. Extraction of the catheter:

The doctor will gently pull out the catheter from the vein. This procedure is usually not painful, but the patient may feel mild discomfort.

5. Care of the insertion site:

After the PICC line is completely removed, the insertion site will be covered with a sterile dressing to protect it and prevent potential bleeding.

6. Verification and advice:

Medical staff will inspect the insertion site to ensure there are no issues. The patient will receive instructions on how to care for the insertion site after the removal of the PICC system.