PICC (peripherally inserted central catheter)

PICC line is a thin, soft, long tube (catheter) that is inserted into a vein in the arm, leg or neck. The tip of the catheter is positioned in a large vein that carries blood into the heart. The PICC line is used for long-term intravenous (IV) antibiotics, nutrition or medications, and for blood draws.

Procedure

First an ultrasound is performed to evaluate the access vein. Then an interventional radiologist or nurse will insert the PICC line, using live X-ray (fluoroscopy) to assist with proper location. If properly cared for, a PICC line can stay in for weeks to months.

Anesthesia

Younger patients are usually given IV sedation so they aren't awake during the procedure. If the child is older or has medical problems that prevent us from giving IV sedation, we will use only local numbing medicine.

Pain

If your child is awake, he or she will feel a small needle prick when we inject the local numbing medicine.

Risks

The procedure is considered low-risk. However, potential complications include:

• Bleeding
• Infection
• Formation of a blood clot in the vein (thrombosis)
• Abnormal heart rhythm
• Puncture of adjacent structures (such as other veins or arteries)
• Contrast reaction (allergic reaction to the X-ray dye)

Bathing

Gauze and a clear bandage will be placed over the PICC line. The bandage must remain dry at all times while the PICC line is in place. Approximately two days after the PICC line is placed, a nurse at the hospital or a home-care nurse will perform the first bandage change. After this, it is OK to shower as long as the PICC line is covered with a water-resistant bandage. You will be shown how to make a water-resistant bandage. You may also sponge-bathe your child, as long as you keep the PICC site dry at all times.

Restrictions

Your child should be discouraged from activities, such as football and rough playing, which may result in a pull to the PICC line and lead to damage or loss of the catheter.