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PICC Line

Josephine

NURSE DIRECTOR EMERITUS
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What is a Peripherally Inserted Central Catheter?

A PICC is used for the long term delivery of intravenous medication, chemotherapy and fluids. It is often recommended when suitable veins for injections are difficult to access.


A PICC is a long thin soft tube that is inserted into a large vein and threaded through your veins until the tip is in a large vein near the heart. The most frequent site is the bend of the elbow but actually, almost any site can be used, hand, foot, groin, anywhere a large vein can be accessed.

PICC line.jpg


PICC insertion
Ultrasound is used to find a vein on the inside of your arm and to guide the radiologist through the procedure. A local anaesthetic is given before the PICC line is inserted. The procedure can take up to one hour to complete.


PICC dressing
The PICC is secured using a waterproof dressing and a type of clamp. This is important for keeping the area clean and dry as well as preventing the PICC line from being accidentally removed or dislodged.


PICC_line.jpg



There is often a small amount of bleeding around the insertion site during the first 24 hours. The nursing staff caring for you will replace the dressing the day after the PICC has been inserted. Should you notice water under the dressing or the dressing begins to lift off, you must let the nurse or doctor know immediately.

A tubifast may also be placed over the PICC dressing for support and comfort.

PICC_tubifast.jpg


General care
For the first 2 hours after insertion, restrict arm movement to minimise bleeding and promote comfort.


While the PICC is in place:
avoid heavy physical activity, such as lifting or digging or sports that are either
vigorous or involve contact
avoid submerging your arm in a bath
avoid using scissors or sharp objects near your PICC line
make sure the dressing remains dry and intact
before showering, cover the PICC with plastic wrap. The plastic wrap should

encircle the arm, without pressure and tape applied to the top and bottom to prevent the dressing from getting wet.


What can go wrong with my PICC?
Bleeding
You may notice a slight oozing of blood from the insertion site during the first 24 hours after the PICC has been inserted. Time and the application of pressure usually stops this quite quickly with no ongoing problems.

Phlebitis (redness along the arm)
The PICC line can sometimes irritate the inside of the vein wall leading to redness, swelling and pain for the first 24-72 hours after insertion. This is not usually an infection but the body’s response to foreign material. Warm hot packs to the area 3-4 times a day can bring relief and symptoms should subside in a few days.

Infection
Common signs and symptoms of infection are pain, redness, warmth or discharge from the insertion site; feeling unwell or nauseous; a rise in body temperature.

If you experience any of the following you should seek medical attention urgently as it may indicate that you have a blood stream infection:

fever (temperature greater than 38 degrees) and chills - with or without fatigue, loss of appetite. In order to prevent an infection, your PICC should remain covered with a dry waterproof dressing.

Thrombosis
The PICC can rub against and irritate the internal vessel wall of the vein causing a blood clot (thrombosis) to form. The signs and symptoms of thrombosis are pain along the vein and neck; swelling in the arm, neck or face; a change in skin temperature and colour. If you suspect a clot please go to your nearest hospital emergency department.


Catheter tip movement
Catheter tip movement within the body can be triggered by excessive coughing, vomiting, sneezing or hiccupping. Signs and symptoms include pain or discomfort in the shoulder, jaw, ear or neck. Excessive use of the arm with the PICC can also cause the catheter tip to be dislodged


At every dressing change your nurse should measure the length of your PICC line and cross check this measurement with the initial length of your PICC when it was inserted.

Should any of the above problems occur it is essential that you notify the nursing team caring for you as soon as possible. See contact numbers below.

Frequently asked questions
Does the PICC always need a dressing?
Yes, to keep it in place, prevent damage to the catheter and protect the site from infection.

Can I shower or bath?
If the PICC gets wet it will increase the risk of infection. You can shower provided that the PICC line has a dressing and in addition you cover the PICC with plastic wrap to protect it from getting wet.

What happens if the PICC gets pulled out?
If your PICC gets pulled out, apply pressure to the insertion site which will stop the bleeding and notify a nurse as soon as possible.

SOURCE: PICC lines (peripherally inserted central catheters)
 

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