Indications for Needing a PICC Line 

Peripherally inserted central catheters are used to obtain central venous access in patients undergoing treatment in acute care facilities, home health agencies and skilled nursing care in a variety of settings. PICC

IndicationsLong Term Chemotherapy: Chemotherapy is medication administered to treat some types of

cancer. Chemotherapeutic drugs can be administered either orally or intravenously

depending on the type of the medication. Some of the agents cause damage to the tissues and require

infusion into large vessels to minimize, if not eliminate, such damage. T

Hyperalimentation: Hyperalimentation is a form of nutrition that does not utilize the digestive system. It nourishes the body completely through IV access and given to patients who are unable to process and absorb nutrients because of persistent vomiting, severe diarrhea or intestinal diseases. All the proteins, calories, vitamins and minerals can be given through the venous system but must be given through a central vein, such as the Superior Vena Cava (SVC), to prevent complications. Hyperalimentation is usually continued for long periods of time and because a PICC line can remain for such duration, it is ideal for this use.

Repeated Administration of Blood or Blood Products: Patients with blood disorders, such as anemia, low platelet counts, or coagulation disorders, may require repeated blood or blood products. Especially in neonates.

Reduced Number of Needle Punctures to Skin:

Measurement of Central Venous Pressure: Central venous pressure monitoring is often obtained in patients with cardiovascular disturbances, especially those undergoing treatment in ICU. Since the tip of the PICC line is advanced near the heart, it can be used to measure the central venous pressure. This helps in assessing the status of the patient and to determine whether he is improving or deteriorating. 

Benefits of PICC Lines

ong term venous access: A peripherally inserted central catheter is an ideal venous access device for patients with chronic diseases requiring long term intravenous therapy such as, for example, antibiotics or nutrition. Depending on the facility or institution, a conventional peripheral venous catheter is typically changed to another site every three to five days.Low Risk for Infection: Besides prepping the site with a CDC recommended Chloraprep and utilizing sterile technique during insertion, a disc impregnated with Chloraprep is applied at the insertion site with each dressing change. In addition to insuring the dressing remains clean, dry and intact, use of Chloraprep further decreases risk of infection. Additionally, the insertion site of a PICC, typically, is the upper arm.Decreased Skin Puncture for Blood Sampling: 

Versatility: PICC lines, with their multi lumened IV access, can be used to administer antibiotics, blood and blood products, anti-cancer drugs, intravenous fluids and nutrients. It is a versatile IV access line.

Risks of PICC Lines

Air Embolism: Air bubbles may enter the blood vessel during insertion of a PICC

Infection: Phlebitis:

Catheter Malposition: Malposition can occur during PICC insertion or later due to changes in pressure inside the chest or from catheter migration. After the insertion of catheter, the position of its tip is confirmed via x-ray. Confirmation of proper tip placement is required before using the device as a malpositioned catheter can cause serious complications.

Equipments mostly used In NICU 1.sterile gown ,3 drapes,picc line set, sterile strips, tegadrum 2,3 way stopper or heplock,2 sterile gauze pack ,one 25 cc normal saline for flush,g.p pack or UA sterile procedure set,2 sterile gloves as required size of operator,1 mask,1 cap, two 3 cc syringes, sterile pivodine,

A type of PICC line

Procedure:1.The operator must hand wash with soap and water then with pivodine.2.Wear servile gown gloves, cap and mask by assistant or assigned R.n.3.Make a privacy ,make a sterile field ,cover the site hole ,first apply pivodine by assistant then spray with haxiprap(15 seconds give drying).4.slect the vein for insertion ,measure it by from selected 1.vein tip to clavicle joint(this is for upper extremity),2.measure it selected vein tip tp umbilicus.5.Then insert the canola , look for blood is coming in satellite if blood come then gently inert the line till measure as 11 or 12(mostly in preterm 0.9kg),if conform that it is in heart break the satellite gently and then apply sterile strip on it ,round the other part of line and then tegadrum apply, x-ray should be do for conformation.