What is a PICC Line? For Parents

What is a PICC Line?

A peripherally inserted central catheter (PICC line) is a type of central line. A central line (also called a central venous catheter) is like an intravenous (IV) line. But it is much longer than a regular IV. A PICC line is a thin, soft, long catheter (tube) that is inserted into a vein in your child’s arm, leg or neck. The tip of the catheter is positioned in a large vein that carries blood into the heart, and goes all the way up to the heart or just inside the heart. The other end of the PICC line stays outside of the body, usually where the arm bends. It may divide into more than one line. The end of each line is covered with a cap.

A patient can get medicine, fluids, blood, or nutrition through a PICC line. The PICC line is used for long-term intravenous (IV) antibiotics, nutrition or medications, and for blood draws. An X-ray will be taken to be certain that the PICC is in the correct place before it is used.

Why use a PICC line instead of a regular IV (Intravenous)?

A PICC line is thicker and more durable than a regular IV. It’s also much longer and goes farther into the vein. Health care providers use a PICC line instead of a regular IV line because:

It can stay in place longer (up to 3 months and sometimes a bit more).
It lowers the number of needle sticks a child needs for blood draws.
Patients can get large amounts of fluids or medicines (like chemotherapy) that might not go through regular IVs.

A PICC line can help someone:

with a serious infection so they can get IV antibiotics for a few weeks
with cancer so they can get chemotherapy and blood tests through the line
who needs IV nutrition
who will need many blood transfusions

How is a PICC line placed?

We will give your child an ultrasound to evaluate the vein where we will insert the PICC line. Then, using live X-ray (fluoroscopy), an interventional radiologist or nurse will insert the PICC line. (Your child will be protected by an X-ray shield.) Health care providers place PICC lines in an operating room, intensive care unit, or interventional radiology suite. The patient is sedated (given medicine to relax) or gets general anesthesia (to go to sleep) so they won’t feel pain.

To place the line, a health care provider will:

Clean and numb the skin where the PICC line goes in.
Put the PICC line into a vein (usually a vein where the arm bends) using ultrasound to guide where the line goes.
Thread the PICC line up to a large vein near heart.
Check the placement of the PICC line with an X-ray.
Place a dressing (bandage) over the PICC line.

Putting in a PICC line takes about 15–20 minutes, but can take up to 60 minutes.

If properly cared for, a PICC line can stay in for weeks to months.

Younger patients are usually given IV sedation so they aren’t awake during the procedure. If the child is older or has medical problems that prevent us from giving IV sedation, we will use only local numbing medicine.

If your child is awake, he or she will feel a small needle prick when we inject the local numbing medicine.

We will place gauze and a clear bandage, which must remain dry at all times while the PICC line is in place. Approximately two days after we place the PICC line, a nurse at the hospital or a home-care nurse will change the bandage. After this, it is OK to shower as long as the PICC line is covered with a water-resistant bandage. We will teach you how to make a water-resistant bandage.

You may also sponge bathe your child, as long as you keep the PICC site dry at all times.

Your child will be able to resume most activities, including day care or school. Your child should be discouraged from activities, such as football and rough playing, which may result in a pull to the PICC line and lead to damage or loss of the catheter. If you have questions about which activities are OK, please ask your doctor.

Are there any risks with a PICC Line?

Most of the time, there are no problems with a PICC line. If problems do happen, it is usually because the line gets infected or stops working. Very rarely, a PICC line can cause a blood clot. Health care providers review the risks with families before placing the PICC line.

The procedure is considered low-risk. However, potential complications include:

Bleeding
Infection
Formation of a blood clot in the vein (thrombosis)
Abnormal heart rhythm
Puncture of adjacent structures (such as other veins or arteries)
Contrast reaction (allergic reaction to the X-ray dye)

When should I call a doctor?

Check the PICC line area every day and call the health care provider right away if:

There are signs of an infection, such as a fever, redness or swelling near where the line is, or pain or tenderness where the line is.
The line comes out or gets blocked (can’t be flushed).

Call 000 if your child has trouble breathing, suddenly starts coughing, has chest pain, or their lips or nails look blue.

How can I help?

At home, a child’s PICC line needs special care to prevent infection and keep it working well. It’s normal to feel a little bit nervous caring for the PICC line at first, but soon you’ll feel more comfortable. You’ll get supplies to use at home, and a visiting nurse may come to help you when you first get home.

Before your child goes home, ask your health care team:

how often to change the dressing
when and how to flush the line
what to do if the line gets blocked or comes out
how to give medicines through the line (if you will be giving medicines at home)
if the line has caps, how often to change them
which physical activities are OK for your child (most kids need to avoid rough play and contact sports)
if any special care is needed to protect the line while your child bathes
what signs of infection to watch for

Tell your child’s teachers, school nurse, counselor, and physical education teacher about the PICC line. They can make sure your child avoids any activities that may damage the line, and help support your child during treatment.

What is a PICC Line? For Parents