The PICC (Peripherally Inserted Central Catheter) line is a plastic tube that is inserted into a large vein to give intravenous (IV) therapy. This catheter is used when IV therapy will be needed for a long time or when the small veins in the body can no longer be used for IV therapy.
Benefits and uses of the PICC line
There are many benefits to having a PICC line rather than a regular IV, from a child’s point of view. The most important benefit is a lot fewer “sticks” are needed for IVs and for drawing blood. However, please do not tell your child that having a PICC line means he will never have to be “stuck” again.
Other benefits of the PICC line are:
- It can stay in the vein for a long time.
- It is secure in the vein.
- It prevents the “burning” feeling your child sometimes gets when receiving medicine by other IV methods.
Once the PICC catheter is placed in the vein, it can be used to:
- Give medicine
- Give blood and blood products
- Give parenteral (IV) nutrition
- Draw blood samples for testing, depending on your child’s diagnosis.
Inserting the PICC line
The PICC line is a plastic tube that is placed into your child’s arm or leg and manipulated into a larger vein in the chest (Picture 2). Your child may go to the Radiology Department to have the catheter put in. Once the catheter is in place, IV nutrition and medicines may be given and blood may be drawn.
At the catheter exit site, there will be “wings” that will either be stitched to the skin to hold the catheter in place or have an adhesive securing device to hold it in place. These stitches or catheter securing device must stay in as long as the catheter is in place. A sterile dressing is placed over the wings and insertion site to keep them clean and dry.
For 1 or 2 days after the catheter is inserted, the skin may be tender around the insertion site. The soreness will go away within a few days.
Possible problems with the catheter
Some problems can occur with a PICC line. These
- Infection at the skin exit site or in the blood.Some infections can be treated with antibiotics without removing the catheter.In other cases, the catheter must be removed.
- Check the site for redness, swelling, pain or yellow or green drainage.
- Check your child’s temperature every day. If it is higher than 100.4°F, call your child’s doctor.
- Broken catheter outside the body.A hole or tear may develop in the catheter or there may be a break at the catheter hub.If this happens, cover the PICC line with a sterile dressing and notify your doctor or the Radiology Department.
- Blood clots in the catheter or in the vein.Most catheters do not need to be removed if the clot can be dissolved.
- The catheter tip moves out of the correct position in the vein.The catheter may need to be repositioned or replaced.
While your child is in the hospital
While your child is receiving an IV solution through the catheter:
- The end of the catheter will be attached to plastic tubing that runs through a small machine that pumps the solution into the vein.
- The tubing (extension piece) may be coiled on top of the dressing and covered with tape to prevent any pull or strain on the catheter.
- Be very careful that the IV tubing or catheter does not get pulled.It may hurt your child or even break the catheter.Let the nurse know if any part of the catheter comes out from under the tape so it can be secured.
- The sterile dressing on the catheter and the cap (or connector) at the end of the catheter will be changed once a week or if it becomes wet, dirty or loose.
- Never use scissors near the catheter.
- If the catheter is not being used to give medicine, it will be flushed once a day with a medicine called heparin.This will keep blood from clotting in the catheter.
If your child goes home with a PICC line
- A nurse will teach you how to care for the catheter at home. (Some families may be taught to change PICC dressings, but usually a homecare nurse will change it.The dressing may be changed if your child comes back to the hospital for an appointment.)
- You will learn:
- How to flush the catheter with heparin.Heparin is a medicine that keeps blood from clotting in the catheter.
- How to prevent and recognize catheter problems.
- You may learn how to give IV medicine or IV nutrition (TPN) at home, if necessary.
- Please make sure your nurse contacts the unit discharge planner to help you get the supplies you will need to care for the catheter.A home visit from a homecare nurse will also be arranged to finish and go over the teaching and to answer your questions.
- Your child may continue most normal activities while the catheter is in place.
- Contact sports, heavy lifting and swimming are not allowed.
- Showering may be allowed if you put plastic or waterproof tape over the dressing and cap. The dressing must be changed if it gets wet but please check with your doctor or nurse to be sure it is okay to take a shower.
Removal of the PICC line
The catheter will be removed when the IV therapy is completed or if there is a problem with the catheter. This is done by removing either the stitches or the securing device at the exit site and gently sliding the catheter out. It does not hurt.
If you have any questions, be sure to ask your child’s doctor or nurse.
HH-II-137 8/00 Revised 2/18 Copyright 2000, Nationwide Children’s Hospital