Peripherally Inserted Central Catheter
A peripherally inserted central catheter is a long, thin tube that is inserted through a vein in the arm. The catheter is threaded through the arm vein until it reaches a larger vein close to the heart. This is commonly called a PICC line.
Veins in the Arm
Reasons for Procedure
PICC lines may be used if you need:
- Long-term medication treatment and cannot take medication by mouth
- Fluids—if you cannot drink enough to stay hydrated
- Calories that you cannot get by eating
- IV medication—if arm veins are hard to find or use
After the PICC line is in, it can be used for weeks to months.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Bloodstream infection—occurs when bacteria enters the bloodstream through or around the central line
- Abnormal heart rhythm—can occur if the catheter tip is out of place and too close to the heart
- Nerve injury—tingling or pain in the arm where the catheter is inserted
- Blood clots
- Air or catheter embolus—air bubble or part of the catheter blocks a blood vessel
Factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
- You may have your blood drawn to check how well your blood clots.
- Your doctor may ask you questions like whether you have any allergies and which arm is dominant.
- Arrange for a ride home after the procedure, as your arm may be numb.
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
You will be given a local anesthetic to numb the area where the PICC line will be inserted.
Description of Procedure
This procedure is usually done in an outpatient setting, so you will not need to stay overnight in the hospital. If you are already in the hospital for a different reason, this procedure is not likely to extend your stay.
Having a catheter inserted increases your risk of a bloodstream infection. The hospital staff will take steps to reduce this risk.
During the procedure, the staff will:
- Give you an anesthetic.
- Extend your arm away from your body.
- Measure the distance from your arm vein to where the catheter will end.
- Cut the catheter to the correct length. Flush the catheter with salt water.
- Place a tourniquet on your arm. A tourniquet is a device used to slow blood flow.
- Make a small incision.
- Insert the catheter into your vein. An ultrasound may be used to help place the catheter.
- Use sutures or tape to secure the PICC line. Place caps on the end of the catheter.
- Cover the insertion site with a bandage. Write the date of the insertion on or near the bandage.
How Much Will It Hurt?
During the procedure, you will not feel any pain because of the anesthetic. There may be mild discomfort at the insertion site after the procedure.
At the Care Center
Following the procedure, the staff may provide the following care to help you recover:
- Do an x-ray to make sure your catheter is in the correct position.
- Continue to check the insertion site for bleeding.
- Give you medications, fluids, or nutrition through the catheter.
- Flush catheter ports to prevent blood clots.
Take steps to reduce your risk of infection by:
- Thoroughly washing their hands and wearing gloves before touching the catheter or changing the bandage
- Using an antiseptic to clean the catheter opening
- Taking precautions when handling medication, fluid, or nutrition that will be delivered through the catheter
- Watching you closely for signs of infections—These signs include fever, chills, and problems at the insertion site such as redness, swelling, and drainage
- Not allowing visitors in your hospital room when the bandage is being changed
- Keeping the catheter in place only as long as it is needed
There are also steps that you can take to reduce your risk of infection:
- Ask the staff to take every precaution to prevent an infection.
- Tell the staff right away if the bandage needs to be changed or if the site is red or sore.
- Remind everyone entering your hospital room to wash their hands. Do not allow visitors to touch your catheter.
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
- Keep your insertion site clean, dry, and covered with a bandage. Follow your doctor's instructions for changing the bandage.
- Before touching the catheter, wash your hands or use a hand sanitizer. Wear gloves when touching the area.
- If allowed by your doctor, cover the bandage with plastic when showering.
- Do not swim or bathe while your PICC line is in.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Avoid lifting or any kind of activity that may loosen the PICC line.
- Do not allow anyone to touch the catheter or the tube.
- Check the insertion site daily for signs of infection (such as redness or pain).
- Flush the line with saline or heparin as directed.
- Take medication as directed.
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
- Signs of infection—fever, chills, redness, or swelling at the insertion site
- Pain around the insertion site
- Drainage or leakage from the PICC line
- Trouble flushing or inserting fluids into the PICC line
- PICC line falls out or becomes loose
- Arm grows larger in circumference
If you think you have an emergency, call for medical help right away.
American Cancer Society
Family Doctor—American Academy of Family Physicians
The College of Family Physicians of Canada
Caring for your peripherally inserted central catheter. Cystic Fibrosis website. Available at: http://www.cff.org/UploadedFiles/treatments/Therapies/Respiratory/PICC/PICC%20Fact%20Sheet.pdf. Accessed July 8, 2013.
Central venous catheter. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 8, 2013. Accessed July 8, 2013.
FAQs: Catheter-associated bloodstream infections. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hai/pdfs/bsi/BSI_tagged.pdf. Accessed July 8, 2013.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed January 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.