What is a PICC line?

A PICC line (peripherally inserted central catheter line) is used to give someone chemotherapy treatment or other medicines.

A PICC line is a long, thin, hollow, flexible tube called a catheter. It is 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 is not being used.

Sometimes it divides into 2 or 3 lines. This allows you to have different treatments at the same time.

A PICC line

What is a PICC line used for?

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

  • chemotherapy
  • blood transfusions
  • antibiotics
  • intravenous (IV) fluids
  • liquid food if you are not able to eat.

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

If you have a PICC line, you will not 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 is also helpful if you do not like needles.

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

How is a PICC line put in?

A specialist nurse or doctor will put in your PICC line at the hospital. It can either be done in an outpatient department or on a ward. They will talk with you about which arm would be better to use.

Your doctor or nurse may use an ultrasound scan to help them find the best vein to use in your arm. 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.

Then the skin in the area where the line will be put in is cleaned with antiseptic solution. This area is numbed with an anaesthetic cream or injection. When the skin is completely numb, a needle is put into the vein.

The PICC line is threaded through the needle into a large vein that leads to the heart. The needle is removed at the same time. This should not 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.

Possible problems when putting in a PICC line

It is sometimes difficult to thread the PICC line up the vein towards the heart. If there is a problem, it is 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 does not 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 family member, partner or friend how to change the dressing.

When you are at home, it is 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 a PICC line

Infection

It is possible for an infection to develop inside the PICC 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 does not get better, the line may be removed.

Blood clots

It is possible for a blood clot (thrombosis) to form in your vein at the end of the line. You may be given medication to help prevent this. Contact your hospital doctor or nurse if you have:

  • swelling, redness or tenderness in the arm, chest area or up into the neck (on the same side as the PICC line)
  • a swollen hand (on the same side as the PICC line)
  • shortness of breath
  • tightness in your chest.

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

Blocked PICC line

The inside of the line can sometimes become partly or completely blocked. If this happens, it can be difficult to give treatment or to take blood tests through it. The line may be flushed with a solution to try to clear the blockage, or it may need to be removed.

Air in the PICC line

It is 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 is not being used. The line must not be left unclamped when the caps are not in place.

Loose PICC line

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 straight away. 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 broken or cut. Do not use scissors near the PICC line.

It is not very common to get a cut or split in the line. If this happens, try to clamp or tie your line just above the break. This is to seal it between the split and where the line comes out of your body. Contact your hospital straight away. The line may need to be removed if it cannot be repaired.

How a PICC line is removed

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

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