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What is a PICC?

A PICC is short for a peripherally inserted central catheter that is a special type of IV. A PICC line consists of a long plastic tube inserted in a small vein in your arm that extends all the way into the large vein in your chest near your heart.

Why is a PICC needed?

A PICC is usually placed for patients who need repeated intravenous therapy infusions such as chemotherapy, antibiotics, parenteral nutrition, intermittent pain medications, or any other treatment that must be given into the vein. It is used when a patient needs IV medications for a relatively short period of time (weeks to a few months). A PICC line can also be used to withdraw blood for various tests.

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What are the benefits of a PICC?

  • Eliminates frequent, painful peripheral IVs

  • Some medications can be irritating if delivered through a peripheral IV.

  • You can go home with a PICC line and receive medications at home, whereas you cannot go home with a peripheral IV in your arm.

What are the risks of a PICC?

It is relatively low risk to have a PICC.

  • It is a foreign device being placed inside of your body and therefore comes with a small risk of infection.

  • There is also a small risk of clot formation due to the catheter being in the vein. In the rare occasion that this occurs, it can usually be treated by taking blood thinning medications or, if necessary, removal of the PICC and clot.

How is a PICC placed?

The procedure is performed at El Camino Hospital in the radiology department. An entire team will be taking care of you during the procedure including a radiology nurse, a radiology technologist and the physician. In the Interventional Radiology procedure room, the nurse will help you lay on an exam table.  An ultrasound will be done to your arm to visualize a large vein.  Once obtained, your procedure area will be prepped and sterilized.  A numbing medicine will be injected into the area (local anesthetic).  Using ultrasound guidance, this vein will be punctured and a guidewire will be placed in the vein.  Using fluoroscopy (X-ray) guidance, the guidewire is maneuvered to the large central vein near the heart.   Once the wire is in good position the catheter is slid along with guidewire into position.  The catheter will be secured to the skin using a device called a “Stat-lock” and dressings will be applied.  The procedure takes about 10-15 minutes.

What should I expect after the procedure?

You will recover after your procedure for about 30 minutes where your procedure site is monitored and you will be taught how to care for the PICC. Your family will be able to see you soon after the procedure. If you are feeling well, you will be discharged home.

Care at the procedure site:

ALWAYS WASH YOUR HANDS BEFORE TOUCHING THE LINE!

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The PICC line is attached to the skin with a “Stat-lock” device (the white adhesive with arrows that you can see in the picture). Do NOT remove the Stat-Lock adhesive band.

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There is also a small round sponge called a “biopatch” that is used to prevent infections. It should sit atop the entry site of the PICC line.

 

A clear transparent adhesive covers the entire site.

 

The plastic dressing should be changed twice a week or if it gets wet / dirty.

When can the PICC be used?

Your PICC can be used right away.

What type of PICC was placed?

We place only Bard power PICC lines. These PICCs can be used to inject contrast during CT or MRI scans.

What should I watch for?

You may be sore after the procedure, but this should not get worse and should subside in 2-3 days. During this time, you may take a non-steroidal anti-inflammatory medication such as Ibuprofen (Motrin, Advil), Naproxyn (Aleve), Acetaminophen (Tylenol), or other similar over-the-counter medications. If you develop sudden pain or new swelling, call our office (650) 404-8445 or go to the emergency room if after 5pm or on the weekend.

What if the PICC is accidentally removed?

Don’t panic.
If the catheter is still in the skin, tape it in place. Put a bandage in the place.
If the catheter is completely out, then apply pressure on the site for 10 minutes and apply a band-aid.
Once this is done, then contact your interventional radiologist first thing in the morning. You can reach your interventional radiologist at 650.404.8445.

How long can the PICC stay in place?

The PICC can stay in place as long as you need it, though most are only left in place for a month or two. Every PICC line should be removed when it is no longer needed to avoid the risk of an unnecessary infection or formation of blood clots and scarring in the veins.

What are the signs of an infection?

​Sometimes you may have redness, pain and swelling at the insertion site, but this is relatively rare. It may indicate a local infection at the insertion site. Most often the only sign of a PICC line infection is fever. Therefore if you develop fever, we may have to remove the line to culture the tip.

How is the PICC removed?

PICC lines can be removed by any physician or nurse by simply removing the dressing, peeling off the Stat-Lock, and withdrawing the PICC line – then holding pressure at the site for 5-10 minutes and applying a band-aid. But if you have any questions or need someone to help with this, you can call the Interventional Radiology Clinic at (650)404-8445.

When should you call your physician?

Fever > 101 F or chills
Worsening of redness or worsening of pain in the procedure area
New arm swelling
Problems when using the PICC

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You can reach your Interventional radiologist at 650-404-8445 (ask for the Interventional Radiology Clinic)

General Instructions:

Activity

  • You may resume your regular activities (including driving), unless restricted for other reasons.

  • Other than swimming or submerging the PICC line in a tub, there is no other significant activity restriction while using your PICC.

Pain Management

  • You may use over the counter medication such as Acetaminophen (Tylenol) or Ibuprofen (Advil /Motrin) for minor discomfort, unless you are restricted from taking these medications.

  • If you feel that Tylenol or Advil are not enough for pain control, please contact the Vascular and Interventional Radiology Clinic at 650-404-8445.

Diet

  • You can resume your normal diet. Some patients may develop nausea after the sedation. Therefore light meals are recommended until you know that you can eat without problems.

Shower

  • You can take a shower tonight. You should not soak the PICC in water (eg. bath and swimming pool).

  • You should cover your line with plastic (Seran Wrap) when you shower to keep it dry.

  • After you shower, you should pad it dry. If the dressing beneath the plastic is wet, place a new dry dressing.

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