Introduction

Peripherally inserted central catheters (PICC) are vascular access devices used in inpatient and outpatient settings. Inpatient PICC lines provide central venous access with a safety profile similar to centrally inserted central catheters (CICCs). In the outpatient setting, PICCs have been associated with fewer central line associated bloodstream infections (CLABSI) than CICCs (Grau D. 2017). PICC placement is generally well tolerated by patients who appreciate the convenience of reduced frequency of peripheral IV insertions.

PICC lines are used for short-term or extended therapy, usually from 7 days up to a year. PICCs are indicated for:

Patients with limited peripheral access
Long-term IV medication administration (antibiotics, antifungals)
Continuous administration of vesicants or drugs that irritate peripheral veins (vasoactive drugs, chemotherapeutic agents)
Delivery of hyperosmolar solutions or substances with extreme pH (total parenteral nutrition)
Blood product infusions
Frequent blood draws
Patients with coagulation disorders (thrombocytopenia)
Major anatomic abnormalities in the chest and neck can make CICC placement difficult. (Gonzalez 2021)

This course will review the risks and benefits of PICC lines, identify insertion and removal considerations, discuss care and management of a PICC line and patient education for home care. The procedures outlined here are based upon an evolving standard of care and manufacturer's guidelines. Institutions may have slightly different policies and procedures. Your facility's policies and procedures are your best guide to safe patient care.

Gonzalez R, Cassaro S. Percutaneous Central Catheter. [Updated 2020 Sep 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459338/

Grau, D., Clarivet, B., Lotthé, A., Bommart, S., & Parer, S. (2017). Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study. Antimicrobial resistance and infection control, 6, 18. https://doi.org/10.1186/s13756-016-0161-0