421:, and may range from 2 to 6. The number of lumens may vary from one to three, allowing for concurrent administration of different medications which cannot be mixed. Catheters are also manufactured from multiple materials, including silicone and polyurethane. The insertable portion of a PICC varies from 25 to 60 cm in length, which is sufficient to reach the desired end position in most cases. Some catheters are designed to be trimmed to the required length before insertion whereas others are simply inserted to the needed depth with the excess remaining outside the body. Catheters are supplied with a guidewire. This wire is provided to stiffen the (otherwise very flexible) line so it can be more easily threaded through the veins, and is removed after insertion. Some PICC lines are manufactured with an antimicrobial coating intended to reduce the chance of an infection from the line, but these are not yet in widespread use.
329:
234:
337:
38:
135:
451:
during which the wound can close and begin healing. Usually, a smaller adhesive bandage can be placed over the wound site after the gauze is removed if the wound is slow to heal. The tip of the catheter is sent for microscopy culture and sensitivity (MCS) if the patient is systemically unwell at the time of removal of the PICC. In certain units, it is sent as routine investigation.
416:
is large enough for a PICC line, but is also located close to other features such as the brachial artery and plexus. Imaging is commonly used to evaluate the length and path of the potential veins before the practitioner selects the most appropriate vein. The catheter size for PICC lines is generally
450:
In most cases the removal of a PICC is a simple procedure. Generally, the catheter line can be safely and quickly removed by a trained nurse, even in the patient's own home, in a matter of minutes. After removal, the insertion site is normally bandaged with sterile gauze and kept dry for a few days,
433:
environment surrounding the insertion site. This involves cleaning the skin around the site, as well as the use of a sterile gown, gloves, and drape to reduce the risk of environmental contamination. After the skin is prepared, an incision is made and a device called an "introducer" is inserted into
241:
Generally, PICC lines are considered when a person is expected to need more than two weeks of intravenous therapy. A PICC line can remain inserted for an extended period of time compared to other forms of central IV access, ranging from seven days up to several months as long as the line remains
569:
Chopra V, Flanders SA, Saint S, Woller SC, O'Grady NP, Safdar N, et al. (September 15, 2015). "The
Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results From a Multispecialty Panel Using the RAND/UCLA Appropriateness Method".
434:
the vein. The catheter is cut to the desired length if required, and filled with saline for the duration of the insertion. The PICC line is inserted via the introducer device, and threaded through the veins to the desired end location.
686:
Westergaard B, Classen V, Walther-Larsen S (March 2013). "Peripherally inserted central catheters in infants and children - indications, techniques, complications and clinical recommendations: PICCs in children".
269:
A PICC line may not be inserted in a part of the body which is burned or has a local infection. Damage to the skin and surrounding tissue from radiation may also prevent the placement of a PICC line.
820:
281:– a severe bloodstream infection that can be life-threatening. The majority of infections associated with PICC lines occur after a median duration of use of 10 days, and during an
1205:
1185:
1180:
246:(TPN), chemotherapy, or long term medications such as antibiotics. They may also be used to obtain a blood sample if the lumen is of sufficient size (at least 4
55:
1195:
903:
102:
817:
293:. The use of heparin to maintain a PICC line is not universal, as heparin locks have been associated with complications, including heparin-induced
74:
320:
obstructions, depending on the type and severity of the occlusion. A blood pressure reading can not be taken on an arm with a PICC line inserted.
779:
Guidelines for the
Prenention of Intravascular Catheter-Related Infections, Centre for Disease Control 2011; Infusion Nurses Standards, 2010).
81:
935:
253:
To help prevent the line from becoming clogged, the line should be regularly flushed with normal saline, and "locked" by filling it with
88:
412:
may be used, though in some people it will not be possible to advance the line to the desired location through the cephalic vein. The
792:
70:
793:"Safety of Catheter Lock with or Without Heparin in Implanted Central Venous Catheters - Related Studies - ClinicalTrials.gov"
531:
Hoshal VL (May 1975). "Total intravenous nutrition with peripherally inserted silicone elastomer central venous catheters".
408:
is an appropriate size, but is not preferred in children due to its depth and surrounding tissue. On the other hand, the
242:
viable. They are utilized in both the hospital and community settings. They are commonly used in people receiving total
360:
in the arm, and then threaded through the veins toward the heart, until the end of the catheter rests in the proximal
928:
890:
121:
630:
404:
A PICC line is an invasive medical procedure, and may require local or general anesthesia during the placement. The
95:
1003:
389:
377:
1054:
59:
1249:
972:
225:(air in the pleural space of lung), while PICC lines have no such issue because of the method of placement.
1049:
1021:
921:
332:
Chest X-ray showing tip of PICC line in the superior vena cava. Arrows provided to highlight the PICC line.
313:
1041:
1233:
396:
procedure, but does not need to be performed in a completely sterile environment like an operating room.
429:
While an operating room is not required for the insertion of a PICC line, it is important to maintain a
1139:
1098:
1031:
780:
345:
187:
175:
881:
Bender, C. M., Rosenzweig, M., & Green, E. (2006). "Cancer". In S. Goldsworthy & M. A. Barry.
1254:
1119:
645:
Aljediea, Ibraheem; Alshehri, Mohammed; Alenazi, Khaled; Mimesh, Amr; Fleet, Mustafa (January 2023).
17:
289:, when inserting or using a PICC line will reduce the risk of an infection. There is also a risk of
1175:
1154:
839:"Experience of Radiology Technologists Performing Peripherally Inserted Central Catheters (PICC)"
605:
460:
381:
202:
48:
1070:
838:
646:
418:
328:
247:
214:
179:
1090:
243:
796:
8:
1148:
976:
944:
544:
365:
282:
1275:
712:
361:
191:
171:
1210:
1026:
908:
886:
860:
762:
704:
668:
587:
548:
506:
502:
294:
286:
716:
995:
850:
752:
696:
658:
579:
540:
498:
439:
373:
883:
Medical-Surgical
Nursing in Canada: Assessment and Management of Clinical Problems
178:) or for administration of substances that should not be done peripherally (e.g.,
1013:
984:
980:
824:
757:
740:
210:
1200:
1114:
1075:
741:"PICC-associated Bloodstream Infections: Prevalence, Patterns, and Predictors"
1269:
1170:
959:
864:
672:
647:"Accuracy of Electrocardiography-guided PICC in Atrial Fibrillation Patients"
510:
413:
409:
357:
349:
336:
258:
233:
837:
Aljediea, I.; Alshehri, M.; Alenazi, K.; Memesh, A.; Fleet, M. (July 2021).
606:"Guidelines for the Prevention of Intravascular Catheter-Related Infections"
486:
1228:
855:
766:
708:
663:
591:
465:
405:
353:
237:
A PICC (upper arm) and IV line (elbow area) inserted prior to chemotherapy.
222:
218:
167:
392:
can be used during insertion and to confirm placement. The insertion is a
967:
552:
435:
385:
305:
163:
372:, but also any trained medical professional such as a specially trained
1080:
368:. They must be inserted by a trained medical professional, including a
290:
166:
access that can be used for a prolonged period of time (e.g., for long
913:
739:
Chopra V, Ratz D, Kuhn L, Lopus T, Chenoweth C, Krein S (April 2014).
700:
583:
369:
309:
301:
37:
442:
guidance may be used to monitor the tip position during insertion.
183:
430:
393:
285:
stay. Adhering to strict infection control procedures, including
254:
685:
194:(a central venous trunk), and stays in place (dwells within the
487:"Insertion of long lines in the pediatric emergency department"
278:
836:
644:
317:
206:
186:
that enters the body through the skin (percutaneously) at a
134:
195:
568:
909:
PICC line indications, insertion, care and complications
221:. Subclavian and jugular line placements may result in
300:
Other complications may include catheter occlusion,
277:
As with any intravenous line, there is the risk for
738:
62:. Unsourced material may be challenged and removed.
399:
201:First described in 1975, it is an alternative to
1267:
640:
638:
485:Arnett, A. M.; Fleisher, G. R. (October 1999).
484:
929:
904:Description and images of PICC line insertion
635:
843:The Arab Journal of Interventional Radiology
651:The Arab Journal of Interventional Radiology
612:. Centers for Disease Control and Prevention
936:
922:
610:Centers for Disease Control and Prevention
564:
562:
272:
854:
756:
734:
732:
730:
728:
726:
662:
122:Learn how and when to remove this message
27:Catheter intended for long periods of use
335:
327:
232:
156:percutaneous indwelling central catheter
133:
71:"Peripherally inserted central catheter"
943:
679:
559:
14:
1268:
1145:Peripherally inserted central catheter
723:
530:
144:peripherally inserted central catheter
138:Typical PICC line with a double lumen.
917:
885:(1st Canadian ed.). Mosby: Toronto.
545:10.1001/archsurg.1975.01360110190032
378:Interventional Radiology Technogists
264:
60:adding citations to reliable sources
31:
689:Acta Anaesthesiologica Scandinavica
340:Illustration of fully inserted PICC
24:
875:
198:) for days, weeks or even months.
25:
1287:
897:
818:U Wisconsin, Preparing and Caring
745:The American Journal of Medicine
503:10.1097/00006565-199910000-00004
36:
830:
811:
785:
228:
47:needs additional citations for
773:
624:
598:
524:
478:
400:Selection of vein and catheter
390:electrocardiography navigation
13:
1:
1250:Needle and syringe programmes
471:
758:10.1016/j.amjmed.2014.01.001
424:
384:or chest X-ray, the use of
323:
314:tissue plasminogen activator
7:
572:Annals of Internal Medicine
454:
10:
1292:
1140:Peripheral venous catheter
781:Centre for Disease Control
445:
182:a.k.a. pressors). It is a
176:total parenteral nutrition
1255:Supervised injection site
1242:
1221:
1163:
1132:
1107:
1089:
1063:
1040:
1012:
994:
958:
951:
316:(tPA) may be required to
827:, accessed July 24, 2013
491:Pediatric Emergency Care
344:A PICC is inserted in a
203:central venous catheters
1206:Thermodilution catheter
1155:Central venous catheter
823:August 4, 2013, at the
461:Central venous catheter
273:Risks and complications
1071:Immunoglobulin therapy
856:10.1055/s-0041-1739303
664:10.1055/s-0043-1764199
341:
333:
238:
180:antihypotensive agents
139:
339:
331:
236:
215:internal jugular vein
190:site, extends to the
137:
1196:Implantable catheter
1091:Parenteral nutrition
244:parenteral nutrition
56:improve this article
1149:Seldinger technique
977:Fresh frozen plasma
960:Blood-based product
945:Intravenous therapy
578:(6 Suppl): S1–S40.
366:cavoatrial junction
283:intensive care unit
170:regimens, extended
1055:Sodium bicarbonate
952:Infused substances
362:superior vena cava
342:
334:
239:
192:superior vena cava
172:antibiotic therapy
140:
1263:
1262:
1211:Dialysis catheter
1128:
1127:
799:on August 1, 2013
701:10.1111/aas.12024
440:echocardiographic
295:thrombocytopaenia
287:aseptic technique
265:Contraindications
261:when not in use.
154:), also called a
132:
131:
124:
106:
16:(Redirected from
1283:
1050:Ringer's lactate
1022:Ringer's lactate
1004:Hemoglobin-based
996:Blood substitute
956:
955:
938:
931:
924:
915:
914:
869:
868:
858:
834:
828:
815:
809:
808:
806:
804:
795:. Archived from
789:
783:
777:
771:
770:
760:
736:
721:
720:
683:
677:
676:
666:
642:
633:
628:
622:
621:
619:
617:
602:
596:
595:
584:10.7326/M15-0744
566:
557:
556:
528:
522:
521:
519:
517:
482:
374:registered nurse
127:
120:
116:
113:
107:
105:
64:
40:
32:
21:
1291:
1290:
1286:
1285:
1284:
1282:
1281:
1280:
1266:
1265:
1264:
1259:
1238:
1217:
1164:Other equipment
1159:
1124:
1103:
1085:
1059:
1036:
1014:Volume expander
1008:
990:
985:Cryoprecipitate
981:Cryosupernatant
947:
942:
900:
878:
876:Further reading
873:
872:
835:
831:
825:Wayback Machine
816:
812:
802:
800:
791:
790:
786:
778:
774:
737:
724:
684:
680:
643:
636:
629:
625:
615:
613:
604:
603:
599:
567:
560:
529:
525:
515:
513:
483:
479:
474:
457:
448:
427:
402:
346:peripheral vein
326:
275:
267:
231:
211:subclavian vein
162:, is a form of
128:
117:
111:
108:
65:
63:
53:
41:
28:
23:
22:
15:
12:
11:
5:
1289:
1279:
1278:
1261:
1260:
1258:
1257:
1252:
1246:
1244:
1240:
1239:
1237:
1236:
1231:
1225:
1223:
1222:Specific risks
1219:
1218:
1216:
1215:
1214:
1213:
1208:
1203:
1198:
1193:
1188:
1183:
1173:
1167:
1165:
1161:
1160:
1158:
1157:
1152:
1142:
1136:
1134:
1130:
1129:
1126:
1125:
1123:
1122:
1117:
1115:Drug injection
1111:
1109:
1105:
1104:
1102:
1101:
1095:
1093:
1087:
1086:
1084:
1083:
1078:
1076:Gamma globulin
1073:
1067:
1065:
1061:
1060:
1058:
1057:
1052:
1046:
1044:
1038:
1037:
1035:
1034:
1032:Sugar solution
1029:
1024:
1018:
1016:
1010:
1009:
1007:
1006:
1000:
998:
992:
991:
989:
988:
970:
964:
962:
953:
949:
948:
941:
940:
933:
926:
918:
912:
911:
906:
899:
898:External links
896:
895:
894:
877:
874:
871:
870:
829:
810:
784:
772:
751:(4): 319–328.
722:
695:(3): 278–287.
678:
634:
623:
597:
558:
523:
497:(5): 318–321.
476:
475:
473:
470:
469:
468:
463:
456:
453:
447:
444:
426:
423:
401:
398:
325:
322:
274:
271:
266:
263:
230:
227:
130:
129:
44:
42:
35:
26:
9:
6:
4:
3:
2:
1288:
1277:
1274:
1273:
1271:
1256:
1253:
1251:
1248:
1247:
1245:
1241:
1235:
1234:Extravasation
1232:
1230:
1227:
1226:
1224:
1220:
1212:
1209:
1207:
1204:
1202:
1199:
1197:
1194:
1192:
1189:
1187:
1184:
1182:
1179:
1178:
1177:
1174:
1172:
1171:Infusion pump
1169:
1168:
1166:
1162:
1156:
1153:
1150:
1146:
1143:
1141:
1138:
1137:
1135:
1133:Access points
1131:
1121:
1120:Ascorbic acid
1118:
1116:
1113:
1112:
1110:
1106:
1100:
1097:
1096:
1094:
1092:
1088:
1082:
1079:
1077:
1074:
1072:
1069:
1068:
1066:
1062:
1056:
1053:
1051:
1048:
1047:
1045:
1043:
1039:
1033:
1030:
1028:
1027:Normal saline
1025:
1023:
1020:
1019:
1017:
1015:
1011:
1005:
1002:
1001:
999:
997:
993:
986:
982:
978:
974:
971:
969:
966:
965:
963:
961:
957:
954:
950:
946:
939:
934:
932:
927:
925:
920:
919:
916:
910:
907:
905:
902:
901:
892:
891:0-7796-9969-6
888:
884:
880:
879:
866:
862:
857:
852:
848:
844:
840:
833:
826:
822:
819:
814:
798:
794:
788:
782:
776:
768:
764:
759:
754:
750:
746:
742:
735:
733:
731:
729:
727:
718:
714:
710:
706:
702:
698:
694:
690:
682:
674:
670:
665:
660:
656:
652:
648:
641:
639:
632:
627:
611:
607:
601:
593:
589:
585:
581:
577:
573:
565:
563:
554:
550:
546:
542:
538:
534:
527:
512:
508:
504:
500:
496:
492:
488:
481:
477:
467:
464:
462:
459:
458:
452:
443:
441:
437:
432:
422:
420:
415:
414:brachial vein
411:
410:cephalic vein
407:
397:
395:
391:
387:
383:
379:
375:
371:
367:
363:
359:
358:brachial vein
355:
351:
350:cephalic vein
347:
338:
330:
321:
319:
315:
311:
307:
303:
298:
296:
292:
288:
284:
280:
270:
262:
260:
259:normal saline
256:
251:
249:
245:
235:
226:
224:
220:
216:
212:
208:
204:
199:
197:
193:
189:
185:
181:
177:
173:
169:
165:
161:
157:
153:
149:
145:
136:
126:
123:
115:
104:
101:
97:
94:
90:
87:
83:
80:
76:
73: –
72:
68:
67:Find sources:
61:
57:
51:
50:
45:This article
43:
39:
34:
33:
30:
19:
1229:Air embolism
1190:
1144:
882:
849:(2): 88–92.
846:
842:
832:
813:
801:. Retrieved
797:the original
787:
775:
748:
744:
692:
688:
681:
657:(1): 35–38.
654:
650:
626:
614:. Retrieved
609:
600:
575:
571:
539:(5): 644–6.
536:
532:
526:
514:. Retrieved
494:
490:
480:
466:Hickman line
449:
428:
419:French gauge
417:measured in
406:basilic vein
403:
354:basilic vein
348:such as the
343:
312:or low-dose
299:
276:
268:
252:
248:French gauge
240:
229:Medical uses
223:pneumothorax
219:femoral vein
209:such as the
200:
168:chemotherapy
159:
155:
151:
147:
143:
141:
118:
109:
99:
92:
85:
78:
66:
54:Please help
49:verification
46:
29:
1064:Medications
968:Whole blood
803:February 5,
436:Fluoroscopy
386:fluoroscopy
291:blood clots
164:intravenous
1081:Interferon
631:valved PIC
472:References
382:ultrasound
318:break down
188:peripheral
112:April 2011
82:newspapers
1276:Catheters
865:2542-7075
673:2542-7075
533:Arch Surg
511:0749-5161
425:Insertion
370:physician
324:Technique
310:Urokinase
302:phlebitis
205:in major
152:PICC line
18:PICC line
1270:Category
1243:See also
821:Archived
767:24440542
717:10458652
709:23252685
616:July 23,
592:26369828
455:See also
306:bleeding
184:catheter
160:longline
1042:Buffers
516:May 15,
446:Removal
431:sterile
394:sterile
255:heparin
217:or the
96:scholar
889:
863:
765:
715:
707:
671:
590:
553:805577
551:
509:
380:. An
376:. and
279:sepsis
213:, the
98:
91:
84:
77:
69:
1108:Other
1099:Sugar
713:S2CID
388:, or
207:veins
196:veins
174:, or
103:JSTOR
89:books
1201:Port
1191:PICC
973:PF24
887:ISBN
861:ISSN
805:2012
763:PMID
705:PMID
669:ISSN
618:2019
588:PMID
549:PMID
518:2024
507:ISSN
304:and
148:PICC
75:news
1186:MLC
1181:SLC
1176:CVC
851:doi
753:doi
749:127
697:doi
659:doi
580:doi
576:163
541:doi
537:110
499:doi
438:or
364:or
356:or
257:or
250:).
158:or
150:or
58:by
1272::
983:+
859:.
847:05
845:.
841:.
761:.
747:.
743:.
725:^
711:.
703:.
693:57
691:.
667:.
655:07
653:.
649:.
637:^
608:.
586:.
574:.
561:^
547:.
535:.
505:.
495:15
493:.
489:.
352:,
308:.
297:.
142:A
1151:)
1147:(
987:)
979:(
975:/
937:e
930:t
923:v
893:.
867:.
853::
807:.
769:.
755::
719:.
699::
675:.
661::
620:.
594:.
582::
555:.
543::
520:.
501::
146:(
125:)
119:(
114:)
110:(
100:·
93:·
86:·
79:·
52:.
20:)
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
