PICC Line vs. Central Line: Weighing Your Options

Vascular Access refers to the delivery of fluids and medication through the bloodstream. PICCs and Central Lines are two methods of vascular access. Learn the difference between the two, and what are the pros and cons of choosing one versus the other.

what is a PICC line?

A PICC line is a tube that a doctor or a nurse inserts into a vein around the elbow. It is long, thin, and hollow and is used when one requires chemotherapy, intravenous medication or fluids for a long period. It is also used when one requires frequent blood sampling.

For PICC lines, the doctor threads a line along your arm’s vein until the line on your chest forms a large vein. An anesthetic is given to numb the area. After this, you will have an x-ray. The x-ray is done to check whether it is in the right position.

There are various ways of maintaining a PICC line. A dressing that is changed every week helps to hold the PICC line in place. Also, to reduce the risk of infection, the cap at the end of the line is replaced weekly. The line is regularly flushed to prevent it from blocking. Moreover, PICCs can not get wet, or it may cause infections. Patients have to be very careful when they shower. When you shower, you must use a shower sleeve that is waterproof, to prevent any water from coming in. 

Click here for more about PICC line placement and care.

what is a central line?

A central line — sometimes called a skin-tunneled central venous catheter or Groshong or Hickman — is a tube that a doctor or a nurse inserts into a vein located on your chest.  It is used when gaining emergency IV access in case the IV access into an arm vein is impossible. Moreover, it is used after severe blood loss, to monitor central venous pressure during major surgery, when giving blood products, chemotherapy fluids, and other medicines.

It is also used for hyperalimentation, administering long-term IV therapy and drawing blood samples. The process involves the doctor cutting the skin near the collarbone. An anesthetic is given to numb the area. The doctor then threads the line’s tip into a large vein above your heart.

Meanwhile, the other end of the line is tunneled under the skin. It comes out of your chest. To keep it secure, the doctor puts in a stitch. To check the line is in the correct position, an x-ray is needed.

pros of PICC lines

• The whole process is painless.
• They can be used for as long as they are needed even at home.
• The risk of infection is low.
• PICC lines ensure that there is a low risk of irritation and blood vessels damage.

pros of a central line

• The problem of drugs leaking into the tissues is minimized.
• The tubes are also easy to insert and remove.
• Little maintenance is needed.
• There are no needle pokes.

cons of a PICC line

• Possible problems may include infection, blood clots, air in the PICC lines, breaks and cuts of the tubes and accidental disconnecting of the tubes.
• With a PICC line, activities like swimming and bathing are very difficult.
• You have to be very keen on hygiene.
• Some clothes might not fit normally.

cons of a central line

• Possible problems may include clotting of blood, infection, air in the tubes, breakage, blockage and movement out of position of the tubes.
• Daily care is required.
• Supplies are expensive.
• The tubes may restrict some day to day activities.

There are various factors to consider when making a decision on which method best suits you. Consider the maintenance method, infection risks, the risk of drugs leaking into tissues, your ability to perform daily activities, and the exact purpose for which you need your line.  Before meeting with your doctor to decide, think through each factor and write down any questions you may have.  This decision is yours to make, and the more information you can gather — and the more you feel heard — the better the process will be!

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