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How to insert a PICC: practical tips for the intensive care physician

PICCs represent an attractive alternative to centrally inserted central catheters (CICCs) due to the lower incidence of intraprocedural complications and the lower risk of infection. In critical care setting the PICC offers, compared to the CICC with exit site at the neck, several advantages, without risk of pneumothorax during insertion and a greater distance between the exit site and oropharyngeal secretions or tracheostomy. It can also represent an interesting option in the management of patients undergoing noninvasive ventilation with mask or continuous positive airway pressure helmet, due to the possibility of insertion in a semi-seated or prone patient.

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Articles of Interest

Be Picky about your PICCs—Fragmented Care and Poor Communication at Discharge Leads to a PICC without a Plan

PICCs and other CVCs carry equal risk of developing CLABSI in inpatient settings.

How We Do It: Peripherally Inserted Central Catheter Placement (PICC)

Complex central venous access has been a mainstay of the pediatric interventionalist’s practice. Initially introduced in the 1970s for parenteral nutrition,1,2 silastic or polyurethane peripherally inserted central catheters (PICC) are inserted via a peripheral vein. Although the upper arm is the most common entry site, any peripheral vein may be utilized if the diameter is large enough and if the vein is in continuity with central veins and the right atrium.

Inserting a PICC Line

You’ve been told your child needs a PICC line. What is a PICC line and what does this mean for your child and your family?

PICC flushing procedure

If your institution’s policy includes the use of Heparin when flushing central lines, use the SASH method, saline–administer drug or draw blood–saline–heparin.

Vascular Access: How Two RTs Started Doing PICC Lines and More

As one of the first RTS to work in vascular access, Mahoney began sharing his expertise during presentations to groups across the country, including at the AARC Congress. With the news spreading, it was only logical that RTs at other facilities would follow suit if their state licenses would allow it.

What are PICC lines used for?

PICC lines are used when the IV medications or fluids may irritate veins or when medications are given over a longer period of time. For example, chemotherapy can be toxic to the veins if used in a Peripheral IV but if used in a PICC line, the medication will bypass those veins and come only in contact with the central veins.

Resources

Improve PICC

We will improve patient safety by creating, sharing and spreading innovative, high-quality original PICC research

StatPearls

By definition, a central catheter is a venous access device that ultimately terminates in the superior vena cava (SVC) or right atrium (RA). They can be inserted centrally (centrally inserted venous catheter; CICC) or peripherally (PICC). PICCs are placed through the basilic, brachial, cephalic, or medial cubital vein of the arm.