Care for Peripherally Inserted Central Catheter (PICC)

What is Peripherally Inserted Central

Catheter (PICC)?

Peripherally Inserted Central Catheter (PICC) is a long and fine flexible tube that is usually placed into one of the large veins of your arm and passes through to the larger vein near your heart.

The PICC may remain in position for several weeks or months unless it is infected, depending on the length of treatment required.

Below is a diagram of the PICC and illustration of how PICC line enters the vein of the arm.

Central Catheter

Why do I need a PICC?

A PICC is used:

• To give intravenous (IV) fluids, IV nutrition, antibiotics, and other medications directly into the blood stream

• For blood sampling without repeated needle pricks

How is PICC inserted?

• The procedure is usually done under local anesthesia in the procedure room

• You are required to lie down and position your arm in a straight position during the procedure

• One of your arms will be chosen to place the catheter

It usually takes around 40 minutes to complete the procedure. You may be sent for an X-ray after the procedure to check for the placement of the catheter.

After the procedure

You are advised to rest in bed for 4 to 6 hours. Nurse will perform close monitoring regularly to monitor for any abnormalities.

Depending on the anchoring method, stitches may be used to anchor both side of the catheter to your arm. A temporary gauze dressing will be applied over the PICC area for the first day to cover the site.

Subsequently, it will be changed to transparent dressing by your nurse as pictured below: or

What are the potential complications?

PICC is now widely used and it is safe. However, you may need to be aware of the uncommon yet possible complications such as:

• Infection over the insertion area or in the blood stream

• Accidental removal of catheter due to excessive vigorous arm movements

• Tenderness and swelling at the insertion site

• Bruising near the insertion site

How do I take care of my PICC?

Do’s

• Wash your hands before touching PICC and the surrounding area

• Flushing of catheter with normal saline solution will be done by the nurse regularly

• Transparent dressing will be changed by your nurse at least once a week or when necessary

• Tape the catheter to your arm to prevent accidental snagging on objects

• Keep your dressing dry, clean, and intact at all times. Cover the dressing and connector with plastic or waterproof material when showering

Don’ts

• Do not pull on the catheter

• Do not soak the dressing in the water

• No swimming or diving is allowed

• No vigorous arm movements and strenuous exercises. For example, weightlifting or playing tennis

• Do not use scissors or sharp objects to remove tape/dressing from the catheter site

When should I alert the doctor/ nurse?

Call your doctor/nurse immediately if you experience the followings:

• High fever (more than 38°C) or chills

• Redness, swelling, discharge, bleeding, or pain over the insertion site

• Loose or wet dressing

• Loose stitches

• Leaking of fluid from the catheter

• Breakage or any disconnection of tubing

• Catheter slips out from the arm accidentally

What should I do if my PICC comes out accidentally?

• Do not try to push PICC back in

• Inform the nurse/doctor immediately

• Press onto the existing site firmly with a few pieces of gauze for at least 10 minutes

Use bandage to secure if necessary

What is Outpatient Parental Antimicrobial Therapy (OPAT)?

A service that allows you to have your IV antibiotics continued at home or in an outpatient clinic.

You will be assessed by the doctor for your suitability of OPAT and a referral will be made to the specialist doctor and OPAT nurse during your hospital stay.

OPAT nurse will advise you on the important information, such as:

• Treatment details and schedule

• Nurse will assist to put a plaster if bleeding has stopped after that

What do I need to do after removal of PICC?

Removal of the PICC will be done by either a doctor or a nurse after the antibiotic treatment is completed.

After removal of PICC, you should:

• Secure the site with light pressure dressing for 1-2 hours to prevent bleeding

• Apply a plaster over the site after bleeding stops

• Go to the A& E Department if you have any active bleeding over site, shortness of breath or fever

• Treatment charges and Medisave claims

• Follow-up visit