PICC lines are a modern medical device that are commonly used for patients who are in need of intravenous therapy over a long period. Unlike standard IVs which can only be used for a short period of time and can cause damage or scarring to the veins after repeated insertions, a PICC line goes in once (with careful insertion) and can remain for as long as 12 months. Nurses and doctors today have a lot of experience with them, however PICC lines have their own risks. With guidance and proper care, these can be minimized.
We’ve talked about the complications for PICC lines in the past, but today let’s highlight the two more common and serious issues – blood clots and infections. Of the two, blood clots are more common, affecting 20% to 40% of patients. Infections are less common, with the risk being approximately 2%.
blood clots
The most common risk when having a PICC line is a blood clot. When the PICC line is in use for a prolonged period of time, a clot can occur in the vein around the catheter. This clot, known as a thrombosis, can break off and travel around the body, and get caught in the veins and arteries and cause congestion in the area. This is known as an embolism.
how it happens
The embolism slows down blood flow, causing ischemia – the cutting off of blood to a part of the body. The result is cyanosis, where oxygen is cut off from the body part, causing a bluish discoloration in the skin. It’s also possible for the thrombosis to travel into the lungs, causing a pulmonary embolism, a serious condition that can result in lung collapse and death.
how to prevent it
Fortunately, the majority of blood clots are small – minor ones that are not a cause for concern. Your physician will monitor your PICC line weekly to check for any large blood clots. The actual risk for a serious blood clot is very low, and it’s something a doctor can detect with testing. If a clot is found, the PICC line will be removed and anticoagulant medication will be administered for one to two months to dissolve the blood clot.
what to avoid
One precaution you may want to keep in mind is aspirin therapy. Aspirin interferes with your blood’s clotting action. There are cases of people who survived a heart attack or stroke due to taking aspirin after feeling the initial symptoms. Ask your doctor about it, but start a regimen only with a doctor’s supervision.
infections
Although PICC lines are considered minimally invasive compared to other procedures such as central venous catheters, any point of insertion into the body through an incision is at risk for infection. Any infections that occur locally at the point of insertion tend to be mild and easily treatable, but more a more serious systemic infection known as bacteremia, or a blood infection, can occur if the bacteria gets into the bloodstream.
how it happens
A bacteremia is a very serious condition and requires prompt medical attention. You’ll be onset with a sudden fever and chills. If left unchecked, it will spread to the heart and other tissues, which can induce sepsis and eventually septic shock. On septic shock, multiple organs in the body shut down and blood pressure drops, leading to death.
how to prevent it
Avoiding a blood infection is the biggest concern, but it normally is only a risk when local infections are left alone and not treated. An infection itself is not likely to occur if the PICC line is kept clean and dry. A thrombosis from a blood clot can also lead to infection.
Health practitioners today have a lot of experience with PICC line insertion and have protocols in place to minimize the risk of infection, which includes proper hand hygiene, the use of disinfectants on the skin prior to insertion, and various sterile barriers. The next is regular and proper evaluation of the PICC line during your visits, and maintaining the cleanliness of the dressing.
what you can do
The rest of the responsibility lies with the patient. The most important thing is to keep the dressing of the PICC dry. It cannot be wet at any time, whether while taking a shower or during a rain shower. Getting a PICC line cover to keep your PICC line safe and secure is a must.
Wet dressings are a breeding ground for bacteria and raise the risk of infection significantly. If the dressing gets wet, visit your nurse or physician as soon as possible to have the line replaced. Also avoid touching the PICC valve or the dressing, as these should only be handled by a medical professional.
PICC lines are here to help you
PICC lines are a great convenience and can be a huge help to your recovery process, but understanding the risks and knowing how to mitigate them is a huge part of keeping yourself healthy and safe. Read up on it and listen to your doctor, to help prevent any complications.
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