PICC lines

A PICC line is a long, thin, flexible tube called a catheter. It is used to give you chemotherapy and other medicines. A doctor or nurse puts it into a vein above the bend of your elbow. It can stay in place until your treatment is over.

You will be given a local anaesthetic to numb the area before the PICC line is put in. Your doctor or nurse will gently thread the line along the vein in your arm until it’s in a large vein in your chest. You will have an x-ray to check it’s in the correct position.

The PICC line is held in place by a dressing, which is usually changed every week. The cap at the end of the line is replaced each week to reduce the risk of infection. The line is flushed regularly to prevent it becoming blocked.

Contact your hospital doctor or nurse if you have any swelling, pain or leaking fluid around the PICC line. Also tell them if you don’t feel well.

When you no longer need the PICC line, it will be taken out.

What are PICC lines?

PICC lines (peripherally inserted central catheters) are used to give someone chemotherapy treatment or other medicines.

A PICC line is a long, thin, flexible tube called a catheter. It’s put into one of the large veins of the arm, above the bend of the elbow. Then it is threaded into the vein until the tip is in a large vein just above the heart.

The line is usually sealed with a special cap or bung. This can be attached to a drip or syringe containing your chemotherapy or medication. There may be a clamp to keep the line closed when it’s not being used.

Sometimes it divides into two or three lines. This allows you to have different treatments at the same time.

A PICC line
A PICC line

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What PICC lines are used for

A PICC line can be used to give you treatments such as:

It can also be used to take samples of your blood for testing.

If you have a PICC line, you won't need to have needles put in every time you have treatment. This can be helpful if doctors and nurses find it difficult to get needles into your veins. It’s also helpful if you don't like needles.

You can go home with the PICC line in. It can be left in for weeks or months.


How the PICC line is put in

A specialist nurse or doctor will put in your PICC line in an outpatient department or on a ward. They will discuss with you which arm would be better to use.

First, the skin in the area is cleaned with antiseptic solution. Then this area is numbed with an anaesthetic cream or injection.

When the skin is completely numb, a needle will be put into the vein. Your doctor or nurse may use an ultrasound scan to help them find the best vein to use. The ultrasound uses sound waves to produce a picture of the veins in your arm. A small hand-held device is rubbed gently over your arm. This is painless.

The PICC line is threaded through the needle into a large vein that leads to your heart. The needle is removed at the same time. This shouldn't take long and is usually painless. The PICC line will be held in place by a clear dressing.

You will have a chest x-ray to check that the end of the tube is in the right place.

The end of the PICC line comes out just below the crook of your elbow
The end of the PICC line comes out just below the crook of your elbow

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Possible problems when putting in a PICC line

It can sometimes be difficult to thread the PICC line up the vein towards the heart. If this happens, it's usually possible to try again using a different vein.

Sometimes, the PICC line seems to go in easily but the x-ray shows it is not in the right place. If this happens, your nurse or doctor may be able to move it. If that doesn’t work, the PICC line will be taken out and replaced.


Looking after your PICC line

When the PICC line is not being used, there is a slight risk of it becoming blocked. To stop this from happening, a small amount of fluid is flushed into the line using a syringe. This is usually done once a week.

The caps or bungs at the end of the line need to be changed each week to reduce the risk of infection. The dressing also needs to be changed every week. If it gets wet or starts to peel off, it should be changed sooner. It is difficult to change the dressing with one hand, so the nurses at the hospital may do it for you or arrange for a district nurse to visit you at home. They can also teach a relative, partner or friend how to change the dressing.

When you are at home, it's safe for you to have a shower or bath with your PICC line in. Your nurse can give you waterproof covers to stop the line getting wet.


Possible problems with PICC lines

Infection

It’s possible for an infection to develop inside the line or in the area where it goes into the vein.

Contact your hospital doctor or nurse if you have:

  • redness, swelling or pain in the area
  • discoloured fluid coming from the area
  • a high temperature (fever).

If you get an infection, you will be given antibiotics. If the infection doesn’t get better, the line may be removed.

Blood clots

It’s possible for a blood clot (thrombosis) to form in your vein at the tip of the line or around the line within the vein. You may be given medication to help prevent this.

Contact your hospital doctor or nurse if you notice any swelling, redness or tenderness in the arm, chest area, or up into the neck, or if your hand becomes swollen (on the same side as the PICC line).

If a clot does form, you will be given some medication to dissolve it. Your line may have to be removed.

Air in the PICC line

It’s important not to get any air into your PICC line. Not all PICC lines have clamps. Some lines have caps at the end that stop air from getting into the line. If your PICC line has a clamp, it should always be closed when the line isn't being used. The line must not be left unclamped when the caps are not in place.

The PICC line may come out

To stop the line coming out by accident, it should always be taped or covered with a dressing. If the dressing holding the PICC line in place comes loose, tell your district nurse or hospital nurse immediately. Then it can be replaced as soon as possible.

Break or cut in the PICC line

It is important that the PICC line is not cut or split. Don’t use scissors near the PICC line. It’s not very common to get a cut or split in the line. But if this happens, contact your hospital immediately. The line may need to be removed if it can't be repaired.


How the PICC line is removed

When you don’t need a PICC line any more, it will be taken out. A nurse will usually do this for you in an outpatient department. It will be gently pulled out and the area where the PICC line was put in will be covered with a dressing. This is a painless procedure and only takes a few minutes.

Back to Being treated with chemotherapy

Central lines

A central line is a long, thin hollow tube. It is inserted into a vein in your chest to give chemotherapy and other drugs.