PICC Services

PICC Services are sometimes used to describe vascular access services because PICC Line Services or PICC Lines are the most common forms of vascular access via central lines. Unlike virtually all other companies, Vascular Wellness provides timely, standard and advanced vascular access services by credentialed and insured W2 Employees helping to ensure the right line is placed at the right time, the first time. As such, Vascular Wellness “PICC Nurses” truly are Vascular Access Clinicians.  Currently serving NC, SC, and VA, and expanding soon to GA, KY, OH, TN, and WV.

PICC Services

| PICC Line Services

PICC Services or PICC Line Services typically include Ultrasound Guided PICCs, Midlines, Extended Dwell PIVs and PIVs. While such vascular access devices provide effective and efficient vascular access, other vascular access devices that enable vascular access, such as Small Bore Internal Jugular Lines, Femoral Lines, and Axillary Lines as well as Large Bore Lines including Vas Caths for Dialysis and Quad Lumen Lines, provide additional tools when clinically indicated. We refer to these Small Bore and Large Bore Lines as Advanced Lines, and while Vascular Wellness excels in the placement of these advanced lines, very few vascular access nurse clinicians are able to even offer or provide such lines as part of their PICC Line Services, making such PICC Services incomplete. Please see the illustration for Midlines and the most commonly used Central Venous Catheter Lines.

Vascular Access - Central Venous Catheters & Midline Catheter (non-central)

Vascular Access Services & PICC Line Services

Vascular Access Services in Hospitals - Small Bore Central Venous Catheters

PICC Line Placement with ECG Tip Confirmation

PICC Team confirms proper PICC Line Insertion

PICC Line Placement with X-Ray Confirmation

Small Bore Internal Jugular Lines, Femoral Lines, and Axillary Lines

Small Bore Internal Jugular Lines, Femoral Lines, and Axillary Lines are advanced central lines rarely included by companies offering PICC Services severely limiting what vascular access such PICC Services companies can provide at the bedside. In general, an Axillary Catheter Line is placed when there is poor vasculature for access in the upper arm. An Internal Jugular Catheter Line is a good option when in addition to poor vasculature, the patient has upper arm cellulitis, upper extremity deep vein thrombosis (DVT) or kidney disease. If Axillary and Internal Jugular central venous catheter insertion sites are unavailable or the patient has superior vena cava syndrome (SVCS), a block or pinching of the superior vena cave (a major vein that carries blood to the heart), the Vascular Access clinician will insert a Femoral Catheter into the mid-thigh femoral vein ending in the inferior vena cava. These are ultrasound guided placed lines with confirmation of Line insertion and placement by x-ray.

Large Bore Vas Cath for Dialysis and Quad Lumen Lines

Large Bore Vas Cath for Dialysis and Quad Lumen Lines are placed by Vascular Wellness clinicians at the bedside enabling vascular access that, to our knowledge, no company offering or selling PICC Services is able to safely and effectively do across many clients and patients. These Large Bore Central Venous Catheters Lines are often placed in the Jugular and Femoral Veins and provide rapid fluid and blood administration. In addition to trauma and other uses, they can effectively be used as a temporary central line for Dialysis. Like Small Bore Central Venous Catheter Lines, these are ultrasound guided placed lines with confirmation of line insertion and placement by x-ray.
Vas Cath for Dialysis

Vas Cath for Dialysis Patient

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PICC Specialists

We are more than PICC Specialists as our approach to comprehensive Vascular Access Services is different from other PICC providers and specialists.  We are Vascular Access Specialists.  

Vascular Wellness nurse clinicians are Vascular Access Board Certified (VABC), insured, and skill verified W2 employees, meaning that we can ensure quality, reliability and consistent services as compared to a 1099 contractor model. We maintain a high Vascular Access success rate of 98%, 0 insertion related infections, and often same day service delivery, including weekends and holidays, of highly skilled clinicians — all of which are unmatched as our quality metrics include Advanced Lines such as Internal Jugular Lines, Femoral Lines, and Vas Caths for Dialysis.  We are more than PICC Specialists.  

Prior to performing any Vascular Access procedure, the Vascular Wellness clinician reviews the patient’s medical record including history and lab reports, and independently verifies and confirms the doctor’s order. If our clinician disagrees with the prescribing doctor, the clinician will consult with the doctor. Our clinicians have earned the trust of many doctors, and such doctors will defer to the clinician’s recommendation.  Patient safety and vein preservation are critical – which is where Advanced Lines can be significant.     

In states where nurses are permitted, Vascular Wellness clinicians can provide immediate X-Ray Clearance of lines when tip confirmation is not available or appropriate and X-Ray confirmation must be used. This saves money, time, and coordination with a Radiologist or other doctor and enables the lines to be used immediately to avoid delaying treatment. Quicker therapy leads to better outcomes.  

Vascular Wellness clinicians place and insert PICCs and other Central Venous Catheter Lines in infants and children. Vascular Wellness clinicians work with pediatricians and pediatric departments to provide exceptional care at the bedside.  How many other PICC Specialists place pediatric lines?   

Vascular Wellness uses top rated and hospital preferred supplies from Becton Dickinson, formerly Bard (BD). Superior supplies and services help mitigate the potential for poor outcomes such as bad placement, clotting, infections, and other adverse events. 

Vascular Wellness provides policy and procedure consulting and documentation, EHR/CHR Vascular Access configuration, Vascular Access services reimbursement coding consulting and support, and infection control support.

Vascular Wellness delivers more than PICC Services, and we exceed other PICC Specialists. Vascular Wellness is a comprehensive Vascular Access Solution improving patient outcomes, reducing infections and infection risk, promoting infection control, and decreasing costs.

Learn why our clients & patients value our Clinical Expertise & Advanced Lines

Read our Nurse Clinicians in Action series highlighting clinical cases in which our comprehensive vascular access services made all the difference.

PICC EXPERTS

We are more than PICC Experts.  We are Vascular Access Experts.
Below is an overview that provides basic information about PICC Services.

A PICC Line is a Peripherally Inserted Central Catheter line that extends through the skin to a central vein to provide intravenous therapy. Peripheral veins are those veins in a patient’s arms; in other words, not in the center of the patient’s body. The catheter is inserted into a peripheral vein and then guided to a central vein thus, being referred to as a PICC.

PICC Nurses and PICC Teams place PICCs; however, in addition, many PICC Experts also perform Vascular Access by providing Midlines and Extended and Basic Dwell Peripheral IVs, all of which are not central lines. While Midlines may look like PICCs from the outside, the Midline Catheter is shorter than a PICC Catheter, typically ends near the armpit or axilla and, as a result, does not travel to a central vein. The Extended and Basic Dwell Peripheral IV is even shorter than the Midline Catheter and is inserted into a peripheral vein. Unlike Basic Dwell Peripheral IVs, PICCs, Midlines, and Extended Dwell Peripheral IVs are often inserted and guided to the correct placement using ultrasound machines. PICC Nurses will also maintain lines and ensure that the lines are flowing and not clogged or infected.

With respect to PICCs, Midlines, and Extended Dwell Peripheral IVs, a PICC Nurse will use an ultrasound machine to guide the catheter through the peripheral vein to the proper destination. PICC nurses typically use the Modified Seldinger Technique (MST) to help ensure proper placement. Proper placement can be confirmed by Electrocardiogram (ECG) Tip Confirmation technology or X-Ray, depending on circumstances. Subject to each state’s licensing boards and the skillset of the PICC Nurse, certain PICC Experts are permitted and competent to read X-Rays to confirm proper PICC Line Insertion and placement.

Interested in learning about PICC Line and Midline care? Find more here →

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PICC Services – PICCs, Midlines, Extended Dwell Peripheral IVS, and PIVs

PICC Services – PICCs, Midlines, Extended Dwell Peripheral IVs, and Peripheral IVs are just some of the standard options available to obtain Vascular Access; however, unlike Vascular Wellness, they often represent the complete offering of many companies offering PICC Services and PICC Experts. The PICC Nurse will consider the patient’s diagnosis, the patient’s medical history, the type of infusion required including the duration and frequency for such infusion, and the maturity of the patient or caregiver with respect to line maintenance obligations. While the preceding is best practice followed by Vascular Wellness, we do not know if other PICC Services companies have this training or invest this time. A PICC is generally used when the IV medications or fluids may irritate veins and such medications need to be given over a longer period of time. A Midline is used when (i) IV medications or fluids that do not irritate veins need to be given over a few weeks or (ii) typical veins are unavailable, there have been a few unsuccessful attempts at an Extended or Basic Dwell Peripheral IV, or Peripheral IVs simply do not last. An Extended Dwell Peripheral IV is appropriate for (a) IV medications or fluids that do not irritate veins and need to be given over a short period of time and (b) when there is diminished access or there have been unsuccessful attempts at a Peripheral IV. A Peripheral IV (PIV) is appropriate for obtaining lab work and enabling imaging studies such as CT and MRI scans, and the provision of neutral PH IV medications or fluids. In general, PICCs and Midlines have the greatest risk of complications such as bruising, bleeding, infection, infiltration, and blockage, and the PICC Specialists must have the proper skills and experience when performing these procedures.

Patients can be discharged from hospitals with PICCs and Midlines, or PICCs and Midlines can be placed on an outpatient basis, in an outpatient clinic for home health care, and at the patient’s home. In addition, PICCs and Midlines are also often used at Continuing Care Retirement Communities (CCRC) and at senior living facilities. Unlike other companies, Vascular Wellness places single lumen, double lumen, triple lumen and quad lumen PICCs and single lumen and double lumen Midlines at Hospitals, Surgical Centers, Outpatient Clinics, Senior Communities, Patient’s homes and residences, Hospices, and Prisons and Correctional Facilities. Vascular Wellness clinicians go to the bedside wherever the patient is located to help enable the best possible outcome. Vascular Wellness placed the right line at the right time, the first time.

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Vascular Wellnesssm provides clinical vascular access nursing services at the bedside across the Southeast to a diverse client base including Tertiary Hospitals, Community Hospitals, Long Term Acute Care Hospitals, Skilled Nursing Facilities, Surgical and Outpatient Centers,  Hospice, and At-Home care.

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Vascular Wellness
151 Quarrystone Circle
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Cary, NC 27519
919-226-3694

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