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Understanding PICC Lines

PICC stands for “peripherally inserted central catheter.” It is a long tube inserted into the arm and used for intravenous antibiotic therapy.. The tubing that goes into the patients arm is threaded into a very large vein, which connects it to the right side of the heart. By delivering medication so close to the heart, it gets pumped through the body more efficiently.

PICC lines are often used in CF patients because they can last much longer than traditional IV needles. When properly cared for, they can last weeks, or even months. The flexible tubing of the PICC line enables a patient to continue with most normal activities.

Inserting a PICC line is a longer and more difficult process than starting a regular IV. It must be done by a specially trained radiologist, nurse, or other medical professional. The most important part of placing a PICC line is to verify that the tip rests in the correct position near the heart.

The process of inserting a PICC line is as follows:

1. The length of the PICC to be inserted is determined by measuring the distance from the crook of the elbow to the heart.

2. A trained medical professional preps the site (usually the inside elbow of the left arm) with disinfectant.

3. The patient may receive local anesthesia by injection or application of a cream at the site of insertion

4. A small needle is inserted into a large vein in the inside elbow of the left arm.

5. A wire is placed through the needle, then the needle is removed. A special tube called an “introducer sheath” is placed over the wire. This makes sure that the puncture in the arm is large enough for the PICC line.

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5. The PICC line and introducer sheath are fed into the appropriate vein over the wire. Threading stops when the total length inserted matches the length that was measured at the beginning of the procedure.

6. The introducer sheath and wire are removed.

7. The line is capped with a cannula or septum that will be the site of infusion. To verify that the line is in the vein, it is flushed via syringe with 3-5cc of normal saline. The syringe is then used to check for blood return.

8. A chest x-ray is done to confirm that the line is placed in the correct position.

9. The line is flushed with heparin, to prevent clotting in the line.

FAQ about PICC lines:

Can I shower/bathe with it?

Yes, but it needs to be protected as much as possible to keep moisture out of the dressing.

Can I do normal activities with it?

A PICC line should be handled with care. No vigorous activities (such as sports or heavy lifting) should be done within the first 72 hours after receiving a PICC line.

How do I care for the PICC line?

The Cystic Fibrosis Foundation has a PDF available with information about how to care for a PICC line

Does it hurt?

Initially, there is a some discomfort from the procedure of having the catheter inserted. Within a day or two, it will feel better. Most often the discomfort is caused by the dressing irritating the skin around the site.

How long can a PICC line last?

CF patients who have intravenous therapy courses lasting 10-30 days are well suited by a PICC line. Although PICCs cannot be used for extremely long terms (like a portacath) they can last up to 6 months

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How is the PICC line removed?

The catheter is removed by simply taking off the dressing, then pulling the catheter out. Pressure is then applied to the site to reduce bleeding. A bandage can be used to cover it while it heals.