Care of your PICC (Peripherally Inserted Central Catheter)

Information for patients

This leaflet answers common questions about caring for your central venous line. If you would like any further information or have any particular worries, please do not hesitate to contact your named nurse or doctor.

What is a Peripherally Inserted Central Catheter (PICC)?

A PICC is a thin, flexible tube that is inserted into a vein in the upper arm. It is a type of Central Venous Line, which means that the tip of the line is in a large vein near the entrance to your heart. The PICC is threaded along the vein in your arm until the tip sits in a large vein near the centre of your chest. It is designed to administer medications, fluids, blood products, and to take blood samples through.

There are several different types of PICC. We will assess you and decide which is the most appropriate PICC for your needs.

The line is kept in place with a dressing and with a securing device. The securing device is either an adhesive securing device that sticks to your arm, or a special device with flexible securing feet that sit beneath the skin holding the line in place.

Caring for your PICC

If you are an inpatient, your nurses will monitor and care for your PICC. If you are going home with a PICC, then aftercare will be arranged ahead of your discharge. Please ensure you have the contact details of the teams that will be responsible for your PICC before you are discharged, and when to expect your next appointment.

Avoid getting the dressing wet

Ensure the dressing always remains clean and dry. The semi-transparent dressing will be changed at least once per week. It is water-resistant but not water-proof. Showering is fine, but ensure it is covered well with a water proof sleeve and not in the direct line of the spray.

Never open the clamps or remove the end caps from the lumens

These prevent air and germs from entering the blood stream and prevent bleeding from the line.

Avoid sharp objects near your line

You should not use any sharp objects around the line.

Using your line

The end of the line must be thoroughly cleaned with an antiseptic (chlorhexidine) wipe before it is used, and the bungs should be changed at least weekly. Anyone using your line should be trained and should be using a special technique called an ‘aseptic non-touch technique.’ They should not be using a syringe smaller than a 10 mL syringe. Each lumen of your line needs flushing after use to prevent it from becoming blocked.

If you have clamps on your line, ensure they are closed after each use.

Dressing changes, line changes and bung changes are a sterile procedure. If you experience a cold and shivery feeling during or after your line flush then please report it to your team.

Living with your central venous line

Will it be painful afterwards?

Once the local anaesthetic wears off you may find the procedure site tender and uncomfortable – this is normal and should only last a day or two. It is fine to take simple painkillers such as paracetamol if required.

Can I have a bath / shower?

You can shower with a line in, or sit in a bath, but the line MUST not be submerged. There are protective sleeves in the market that you could use to keep your PICC line dry, or alternatively you could cover it with cling film wrapped around your arm. Do not apply any creams or lotions to the insertion site or the line. The line, insertion site or bungs must not be submerged because of the risk of infection.

What happens if something is wrong?

Infection

If you notice redness around the line or a discharge from the entry site or if you have a temperature above 37.5 degrees, fever, chills or feel generally unwell, it could mean that you have an infection.

Signs of a blood clot

Pain, swelling or discomfort in your neck or arm on the side of the catheter insertion could be signs of a blood clot.

Blocked line

If the line becomes blocked, then it may be difficult to aspirate blood or to inject through the line. In most cases, the line should not be used until the problem has been dealt with. Special clot-busting drugs can usually help.

Rare complications

Rarely, the line can irritate the heart and cause abnormal heart rhythms or cause fluid to build up in the sac around the heart. If you feel any palpitations, light-headedness, dizziness or shortness of breath it is important to seek immediate medical advice.

Occasionally, the line can become dislodged. If you notice that the line is further out than normal, then seek immediate medical advice.

You should not feel pain when the line is being used – if you do, then please report this.

Other complications that may occur when the line is in place:

Line falls out

In the unlikely event that this occurs, you should lie down and immediately apply pressure to the site to stop any bleeding. You must get help immediately.

Bleeding from around exit site

Apply pressure to exit site and contact your nurse/doctor immediately.

Line becomes cut / punctured

Inform your nurse / doctor immediately as they will clamp the line to prevent damage caused by bleeding and by air entering the bloodstream.

How is the PICC removed when it is no longer needed?

When you don’t need the PICC line anymore, your nurse will remove the PICC line and will put pressure on the site to prevent bleeding. An occlusive dressing will be applied which should remain in situ for 48 hours.

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and / or specialist one to one care is required.