|Veins in the Arm|
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Reasons for Procedure
- Long-term medication treatment and cannot take medication by mouth
- Fluids—if you cannot drink enough to stay hydrated
- Calories that you cannot get by eating
- IV medication—if arm veins are hard to find or use
- Bloodstream infection—occurs when bacteria enters the bloodstream through or around the central line
- Abnormal heart rhythm—can occur if the catheter tip is out of place and too close to the heart
- Nerve injury—tingling or pain in the arm where the catheter is inserted
- Blood clots
- Air or catheter embolus—air bubble or part of the catheter blocks a blood vessel
What to Expect
Prior to Procedure
- You may have your blood drawn to check how well your blood clots.
- Your doctor may ask you questions like whether you have any allergies and which arm is dominant.
- Arrange for a ride home after the procedure, as your arm may be numb.
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
Description of Procedure
- Give you an anesthetic.
- Extend your arm away from your body.
- Measure the distance from your arm vein to where the catheter will end.
- Cut the catheter to the correct length. Flush the catheter with salt water.
- Place a tourniquet on your arm. A tourniquet is a device used to slow blood flow.
- Make a small incision.
- Insert the catheter into your vein. An ultrasound may be used to help place the catheter.
- Use sutures or tape to secure the PICC line. Place caps on the end of the catheter.
- Cover the insertion site with a bandage. Write the date of the insertion on or near the bandage.
Immediately After Procedure
How Long Will It Take?
How Much Will It Hurt?
- Do an x-ray to make sure your catheter is in the correct position.
- Continue to check the insertion site for bleeding.
- Give you medications, fluids, or nutrition through the catheter.
- Flush catheter ports to prevent blood clots.
Take steps to reduce your risk of infection by:
- Thoroughly washing their hands and wearing gloves before touching the catheter or changing the bandage
- Using an antiseptic to clean the catheter opening
- Taking precautions when handling medication, fluid, or nutrition that will be delivered through the catheter
- Watching you closely for signs of infections—These signs include fever, chills, and problems at the insertion site such as redness, swelling, and drainage
- Not allowing visitors in your hospital room when the bandage is being changed
- Keeping the catheter in place only as long as it is needed
- Ask the staff to take every precaution to prevent an infection.
- Tell the staff right away if the bandage needs to be changed or if the site is red or sore.
- Remind everyone entering your hospital room to wash their hands. Do not allow visitors to touch your catheter.
- Keep your insertion site clean, dry, and covered with a bandage. Follow your doctor's instructions for changing the bandage.
- Before touching the catheter, wash your hands or use a hand sanitizer. Wear gloves when touching the area.
- If allowed by your doctor, cover the bandage with plastic when showering.
- Do not swim or bathe while your PICC line is in.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Avoid lifting or any kind of activity that may loosen the PICC line.
- Do not allow anyone to touch the catheter or the tube.
- Check the insertion site daily for signs of infection (such as redness or pain).
- Flush the line with saline or heparin as directed.
- Take medication as directed.
Call Your Doctor
- Signs of infection—fever, chills, redness, or swelling at the insertion site
- Pain around the insertion site
- Drainage or leakage from the PICC line
- Trouble flushing or inserting fluids into the PICC line
- PICC line falls out or becomes loose
- Arm grows larger in circumference
American Cancer Society http://cancer.org
Family Doctor—American Academy of Family Physicians http://familydoctor.org
The College of Family Physicians of Canada http://www.cfpc.ca
Health Canada http://www.hc-sc.gc.ca
Caring for your peripherally inserted central catheter. Cystic Fibrosis website. Available at: http://www.cff.org/UploadedFiles/treatments/Therapies/Respiratory/PICC/PICC%20Fact%20Sheet.pdf. Accessed July 8, 2013.
Central venous catheter. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 8, 2013. Accessed July 8, 2013.
FAQs: Catheter-associated bloodstream infections. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hai/pdfs/bsi/BSI%5Ftagged.pdf. Accessed July 8, 2013.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
- Reviewer: Michael Woods, MD
- Review Date: 01/2015 -
- Update Date: 05/11/2013 -