Peripherally-Inserted Central
Catheter (PICC)
A peripherally-inserted central
catheter (PICC) is a thin, soft, flexible tube that is inserted into a vein in your arm and threaded to a larger vein near your heart (figure 1). Your PICC allows for a process called infusion. During an infusion, medication, blood products or nutritional supplements are put slowly into your vein through the catheter opening of your PICC.
Your PICC may have one or two catheter openings. These openings are called “ports” or “lumens.” If the PICC has two catheter openings, medication can be given through one opening, for example, while nutrition can be given through the other
opening.
When a PICC is used
A PICC may be used when: • You need intravenous (IV)
medications or nutrition that is thick or irritating to your smaller veins. Intravenous means through a vein. • You need IV medications at home. • You need blood samples drawn
frequently.
• You need blood transfusions frequently.
• You need an IV site more than once a week.
• You have smaller veins in your arm, making it difficult to insert needles.
Your PICC may be inserted while you are in a hospital room, an outpatient area or a special procedure room. You will be asked to lie on a bed or table with your head slightly raised. A member of your health-care team will inject medication under your skin to numb the point at which the catheter will enter your body (catheter
insertion site). A specially trained nurse or physician will insert a needle into a vein. The catheter is threaded into the vein in your arm. Most people do not find this painful, but you may feel some pressure at the insertion site until the needle goes into the vein. After the catheter has been inserted, an X-ray will be taken to check its placement.
A member of your health-care team will cover the catheter insertion site with a transparent dressing. This will help keep the area clean and help prevent infection. After you leave
Your PICC will require regular care. You or a caregiver will need to: • Flush the catheter with heparin.
Heparin is a medication injected into the IV catheter to keep the catheter open and clear of blood clots.
• Change the injection cap(s). • Perform site care which includes
changing the dressing routinely. For information about regular maintenance of your PICC, see the Mayo Clinic publication, Care of Your
Peripherally-Inserted Central Catheter (PICC) After Leaving Mayo Clinic,
MC1482-01.
Care of your PICC
To avoid possible complications, check your catheter insertion site daily for changes in appearance. Look for the following.
• Redness — Slight redness may occur at the site due to the catheter rubbing on the skin (friction). Notify your health-care provider if the redness spreads around the insertion site, or if redness extends in a line up your arm.
Inspection of the catheter insertion site
• Swelling — Swelling around the insertion site and throughout the entire arm may appear. Compare the size of the arm with the catheter to your other arm. If your arm with the catheter is larger, contact your health-care provider.
• Pain — Slight discomfort at the insertion site is expected. Call your health-care provider if pain
increases at the insertion site or elsewhere in your arm or if minor discomfort is accompanied by redness or swelling.
• Drainage — Contact your health-care provider if you have yellow, white or rusty-colored drainage. Bleeding around the insertion site that lasts longer than 24 hours should be evaluated by a health-care provider. • Catheter movement — Check the
length of the catheter that rests on your skin outside of the insertion site each time you do site care. If this length becomes greater than 5
Follow these guidelines after your PICC has been inserted.
• Avoid submerging the PICC or insertion site in water.
• Protect the dressing from getting wet when you shower or bathe. If the dressing becomes wet, site care must be done to apply a new dressing. You may use a shower shield to protect the dressing from getting wet. This device fits over your arm and covers the dressing. A nurse may give you one to use while you are in the hospital. You may buy shower shields at some pharmacies. • Protect the PICC site from trauma
and avoid having your blood pressure taken on that arm.
Activity and bathing
Go to the nearest emergency room if either of the following occur.
• The catheter is accidentally pulled out or breaks off.
• The cap or extension tubing cracks and leaks fluid.
When to seek emergency care
Notify your health-care provider if any of the following occur.
• You have an unexplained fever greater than 100.5 degrees
Fahrenheit (37.5 degrees Celsius).
When to call your health-care
• You cannot remove the tubing from the extension tube.
• You have redness, swelling, sudden new pain, or drainage from the insertion site.
• The catheter length outside the insertion site is more than 5
centimeters (2 inches) longer than its original measurement after
insertion.
• Your arm suddenly becomes more swollen and is larger than your other arm.
• Your dressing becomes soiled or you believe the catheter has been
contaminated.
• You are experiencing chest pain or difficulty breathing.
If you have any questions or concerns, call the appropriate number below and ask to speak to your health-care provider.
Ask your health-care provider to help you fill out the spaces below.
Date inserted _____________________ Total catheter length _______________ centimeters
Length of PICC tube from insertion site to catheter wings ________ centimeters Arm circumference ________________ centimeters
BARBARA WOODWARD LIPS PATIENT EDUCATION CENTER
Mrs. Lips, a resident of San Antonio, Texas, was a loyal patient of Mayo Clinic for more than 40 years. She was a self-made business leader who significantly expanded her family’s activities in oil, gas and ranching, even as she assembled a museum-quality collection of antiques and fine art. She was best known by Mayo staff for her patient advocacy and support.
Upon her death in 1995, Mrs. Lips paid the ultimate compliment by leaving her entire estate to Mayo Clinic. Mrs. Lips had a profound appreciation for the care she received at Mayo Clinic. By naming the Barbara Woodward Lips Patient Education Center, Mayo honors her generosity, her love of learning, her belief in patient empowerment and her dedication to high-quality care.
