PICC Lines – What Are They?

Many IBD patients have experienced needing a different line placement for many reasons; collapsed veins, needing immediate access in a hospital setting and long-term use, for out-patient TPN use, as well as needing access for fluids and other medications when your veins have collapsed or are no longer allowing access for a peripheral IV.

So what is a PICC Line?

A Peripherally Inserted Central Catheter is inserted into an artery access point in your arm. A very small tube is inserted through your arm, threaded through your shoulder and lastly guided and placed into a large blood vessel that leads into your heart.

Insertion

During the insertion, you are awake and surrounded by Interventional Radiology staff who help during the 5 minute procedure. You will be walked through the entire procedure and sometimes you are even able to watch it be placed via the large screen that the techs utilize as they thread the line through the arm, the shoulder, eventually ending inside a vessel into your heart.

After the insertion, an x-ray will be taken to ensure that the placement is where it needs to be. Often, when things are where they need to be, two stitches will be sewn where the PICC line is inserted to ensure there will be no shifting of the line. After your procedure is done, it is wrapped in a dressing for about a day in order to keep any swelling down. Once the procedure is complete, the PICC line is immediately ready to use.

Does it hurt?

95% of the procedure you do not feel anything except the lidocaine where the doctor numbs your artery. This will take a few minutes. For some patients, there can be discomfort anywhere up to 7 days after the insertion.

PICC lines allow blood draws, medication via IV, infusions, TPN (total parenteral nutrition) and immediate access to blood supply when needed. While having a PICC line is extremely convenient for patients whose veins are temporarily inaccessible, patients with any type of line leading into the bloodstream and in this case, a patient’s heart, risks must be assessed.

Are there risks?

Yes, there are absolutely risks when having a PICC line. You cannot get your dressing wet, you have to be very attentive to the skin around the dressing and your overall health. Bathing can be frustrating to many patients, as it’s crucial not to get the dressing wet. This also means no swimming, etc.

Upkeep

When you get your infusions, whether it is a home infusion service or at an infusion center or clinic, Heparin will be used to flush both lines that come out of your arm allowing access to draw blood as well as giving needed fluids/medications/TPN. Your dressing should be changed once a week in a very sterile environment to ensure the area avoids contamination that would lead to infection or sepsis. Each time one of your lines is accesses, it will be sterilized before access. (Not all PICC lines are the same, but many are visually very similar).

Is it permanent?

This type of line is used in short-term settings, from days to weeks to months. Sometimes patients will get a choice between insertion of a short-term PICC line or the option of a port, which can be placed and accessed long-term. PICC lines can be taken out at any time with the assistance of Interventional Radiology.

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