PICCs and Other Central Lines: Weighing Your Options

Vascular access refers to the delivery of fluids and medication through the bloodstream.  When vascular access is required for longer periods of time, it may become problematic to continue placing new IVs.  Central lines — thin tubes inserted into veins for repeated vascular access — are then used.  There are many types of central lines, but one that is commonly used is the PICC (peripherally inserted central catheter).

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 the catheter through your vein until it reaches near your heart, where the blood vessels get much larger and sturdier.  This is simply so that any irritation from the medications does not damage the thinner, more fragile parts of your vein (in your arm).  Before placing the catheter, 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, and should be then protected by a PICC line cover.  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, PICC’s 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.

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.

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.

PICC lines are just one type of central line.  Some treatments may also be possible via midlines (a shorter tube in your arm), ports (inserted directly into the chest), or other types of central lines.  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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