A peripherally inserted central catheter or PICC is used to make it easier for both patients and caregivers in situations where ongoing access to a patient’s bloodstream is required. The medical device is most commonly used to provide medication, chemotherapy, nutrients or fluids, blood transfusions and in situations where ongoing blood monitoring is required.
PICC lines avoid the need for unnecessary needle pokes and insertion for ongoing IV treatments or blood drawing. Instead, caregivers such as nurses (RN), physician assistants (PA), or nurse practitioners (NP) can use the IV line over a longer course of time keeping the patient more comfortable and making treatment less invasive over time. If you wonder where a PICC line is placed, here is an overview of the process.
Where is a PICC Line Placed?
PICC lines are usually inserted through a vein in the upper arm to make it easier to thread it to a large central vein near the heart. PICC lines contain a temporary guidewire to provide more stability and less flexibility during the insertion process. The process to get the PICC line placed in this position is as follows:
- A site is chosen in the patient’s arm. An ultrasound machine provides guidance for caregivers who can assess the veins to ensure they will allow for PICC line insertion.
- The site for the insertion is cleaned.
- Numbing medicine is applied to keep the patient comfortable.
- A small incision is made at the site for insertion.
- The needle is inserted into the skin to reach the vein.
- The caregiver uses the ultrasound machine to follow the placement.
- The PICC line is slowly moved through the vein up the arm and toward the patient’s heart.
- Once the PICC line reaches the heart, ECG Tip Confirmation technology or an X-ray is taken to confirm it is placed in the proper position.
- Adjustments can be made if the PICC line is not placed properly.
- Once the PICC line position is confirmed, the caregiver removes the guidewire.
- The PICC line is secured to keep it in place and avoid accidental removal.
- A dressing is applied to help protect the insertion site and avoid potential infections.
- A cap is placed over the end of the catheter until it is needed, to help avoid infection.
How is a Position Chosen?
A PICC line is typically placed in a position in the patient’s upper arm, just above the elbow. However, an assessment is made to determine whether the vein is healthy enough to support the PICC line. Another consideration is which of the patient’s arm is the most dominant. This is because it is best to place the PICC line in the nondominant arm to a) keep it more comfortable and b) reduce the risk for accidental removal.
How Long Does It Take to Place?
Generally, the entire process takes up to an hour, to assess the site, insert the PICC line and confirm it is placed in the proper position.
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