Vascular Access Peripherally inserted central venous catheter (PICC)

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PICC-Line

PICC-lines are used when a long term central venous access is needed. They can be placed for up to 3 months and are indicated for, but not limited to, the following intravenous therapies:

  • Antibiotic therapy
  • Antiviral therapy
  • Total Parenteral Nutrition (TPN)
  • Chemotherapy
  • High Pressure Injections of Contrast Media for enhanced CT scans
  • Blood Sampling
  • Blood Transfusion
Benefits for patients and medical staff by using a PICC-line.

A PICC-line consists of a thin, flexible plastic tube and is an alternative to the central venous catheter (CVC) due to their lower complication rate and higher dwell time. It is also a great alternative for patients with a silicone or nickel allergy. If used for more than 3 months, an access port (Verlinkung auf Port & Needles) is recommended.

The benefits for both patients and medical staff by using a PICC-line are enormous. 

Implantation Techniques

After local anesthesia a peripheral vein is punctured and is centrally placed in the superior vena cava, whereby using ultrasound guidance is recommended. The ideal catheter tip position is the caudal third of the superior vena cava at the junction to the right atrium. The conventional landmark-technique, fluoroscopy or the ECG method can be used for the monitoring of correct catheter tip placement. It is important to trim the catheter to its correct length before insertion into the vein. Anatomical landmarks and the tape measure can be used to facilitate this procedure. 

The peripherally inserted central catheter is fixed at the puncturing site by a fixation device. It is not recommended to suture the PICC to the skin. The fixation device should be covered with a sterile and transparent dressing.

Hygiene Precautions

Rigorous aseptic rules must be followed according to local protocols before manipulating the PICC-line. Failure to respect these rules can lead to infection, dysfunction and other complications. It is of primary importance that the nursing staff put on a surgical mask, wash hands with an antiseptic soap and put on sterile gloves before starting any manipulation.