IV: PICC Line
A peripherally inserted central catheter (PICC) line is a plastic tube that is inserted into a large vein, usually in the arm or leg, to give intravenous (IV) therapy (Picture 1). The PICC line 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
Benefits to having a PICC line rather than a regular IV:
- Less needle sticks (This does not mean that they will never have to be stuck again.)
- Secure and stays in the vein for a long time
- Gives medicine, blood, and blood products
- Gives parenteral (IV) nutrition or IV fluids
- Used to draw blood samples for testing (This is not always possible. Your child may still need to be stuck for blood draws.
Inserting the PICC Line
Your child may go to the operating room or to Interventional Radiology to have the catheter placed. Once it is in place, IV nutrition and medicine can be given, and blood can be drawn.
- The exit site is where the PICC line comes out of the body (Picture 1). At the exit site, the wings of the PICC will either be stitched to the skin or held to the skin with a special bandage. This keeps the PICC in the right 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 (Picture 2).
- The end of the catheter will be attached to plastic tubing that runs through a small machine that pumps the solution into the vein.
- For 1 to 2 days after the catheter is inserted, the skin may be tender around the insertion site. This soreness will go away within a few days. Ask your child's doctor or health care provider if they can take Tylenol® for pain.
Caring For the PICC
- Anyone caring for the PICC line needs to wash their hands and wear gloves before handling it.
- The tubing (extension piece) may be coiled on top of the dressing and covered with tape. This prevents 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. Tell the nurse if any part of the catheter comes out from under the tape so it can be secured.
- The sterile dressing on the catheter will be changed every 7 days. It may be changed sooner if it gets wet, dirty, or loose.
- The cap (or connector) will be changed depending on the kinds of medicines or fluids your child gets.
- Never use scissors near the catheter.
- If the catheter is not being used to give medicine, it will be flushed 1 time a day with a medicine called heparin. This will keep blood from clotting in the catheter.
- The infusion tubing can get wrapped around a child’s neck. This can lead to choking (strangulation) or death.
- DO NOT leave the infusion tubing where infants or children can get tangled up in it.
- Talk to your child's health care provider or doctor:
- If your child has been tangled in their tubing before.
- To learn the steps to take to help make sure the tubing does not get wrapped around your child’s neck, such as keeping the tubing away from the child as much as possible.
- Any other concerns you may have about the risk of strangulation from infusion tubing.
- If your child is injured by the infusion tubing, please report the event to the FDA. Your report can provide information that helps improve patient safety. The website to make a report is: https://www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=reporting.home
Your child has a higher risk of infection because of their PICC line. Chlorhexidine gluconate (CHG) treatment helps prevent infection. While your child is in the hospital, they will get a CHG treatment 1 time every 24 hours with warmed CHG cloths.
- Your child will NOT get a CHG treatment if they are younger than 2 months of age, have a CHG allergy, their skin is not intact, or they have other reasons why they cannot.
- You may help give your child the CHG treatment by following these steps:
- You will get 6 cloths to use. Use 1 cloth for each arm and leg (4 total). Use 1 for the front and back of the torso (2 total). Wipe with a back-and-forth motion for about 20 seconds on each separate area. Do not reuse any cloths on any areas.
- Do not use CHG cloths on the face, ears, eyes, nose, mouth, or private areas (genitalia). You may use Comfort Bath® cloths to wash these areas.
- Do not wipe the CHG cloths over the PICC line dressing. If the dressing gets wet or becomes loose, tell the nurse.
- Let the skin air-dry. Do not rinse the area with water. Tell the doctor or health care provider if redness, rash, irritation, or an allergic reaction happens on the skin.
- Do not use lotions, creams, deodorant, or powders on any of the days CHG cloths are used.
- Throw the CHG cloths away in the trash. Do not flush them down the toilet.
- Dress your child in new hospital pajamas after each CHG treatment.
Some problems can occur with a PICC line. These may include:
- 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.
- 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 tell the nurse or health care provider right away.
- 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.
Removing the PICC Line
The PICC line will be removed when IV therapy is finished or if there is a problem with the PICC. This is done by removing either the stitches or the securing device at the exit site and gently sliding the PICC out. It does not hurt.
If you will be going home with the PICC line, ask the doctor or health care provider for more information about going home with a PICC line.
If you have any questions, be sure to ask your child’s doctor or health care provider.
When to Call the Doctor
Call your child’s doctor or health care provider if any of the following occurs:
- You notice any redness, tenderness, bruising, swelling, warmth, or drainage at, or near, the PICC skin entry site.
- They have aches, flu-like symptoms, or a fever higher than 100.4° Fahrenheit (F) or 38° Celsius (C).
- There is swelling, tingling, or pain in the arm or leg or near the PICC skin entry site.
IV: PICC Line (PDF), Somali (PDF), Spanish (PDF)
HH-II-137 • ©2000, revised 10/2022 • Nationwide Children’s Hospital