A PICC line is, by definition and per its acronym, a Peripherally Inserted Central Catheter. It is a long, slender, flexible tube that is inserted into a peripheral vein, typically in the upper arm and advanced until the catheter tip terminates in a large vein in the chest near the heart to obtain intravenous access. It is similar to other central lines as it terminates into a large vessel near the heart however, unlike other central lines, its point of entry is from the periphery of the body. Typically the upper arm is the area of choice.
A PICC line provides the best of both worlds concerning venous access. Similar to a standard IV, it is inserted in the arm under the benefits of ultrasound visualization. Also, PICCs differ from peripheral IV access but are similar to central lines in that a PICCs termination point is centrally located in the body allowing for treatment that could not be obtained from standard periphery IV access. In addition, PICC insertions are less invasive, have decreased complication risk associated with them and can remain for a much longer duration than other central or periphery access devices.
Using ultrasound technology to visualize a deep, large vessel in the upper arm, the PICC catheter is inserted by a specially trained and certified PICC nurse specialist. Post insertion at the bedside, a chest x-ray is obtained to confirm ideal placement. The entire procedure is done in the patient’s room or a special PICC room decreasing discomfort, transportation and loss of nursing care.
A PICC line may requested for a variety of treatment options which include some of the following:
• Prolonged IV antibiotic treatment
• IV access obtainable by less invasive and longer lasting methods
• Multiple accesses obtainable with one access line
• TPN Nutrition
• IV access related to physiological factors
• Home or sub-acute discharge for extended treatment
PICCs are frequently used to obtain central venous access for patients in acute care, home care and skilled nursing care. Since complication risks are less with PICC lines, it is preferred over other forms of central venous catheters. A PICC is not appropriate for all patients. Proper selection to determine the appropriateness of this device is required.
The PICC may have single or multiple lumens (ports). This depends on how many intravenous therapies are needed. A PICC line can be used for antibiotics, pain medicine, chemotherapy, nutrition, or for the drawing of blood samples. PICCs can be inserted by radiologists, physician assistants or certified registered nurses. They are inserted using ultrasound technology at the bedside or ultrasound with fluoroscopy. Chest radiographs are also used to confirm placement of the PICC tip if it was not inserted using fluoroscopy.
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