Outpatient Antibiotic Treatment

How you prepare

To prepare for insertion of a peripherally inserted central catheter, also called a PICC line, you might have tests and talk about your health history with a healthcare professional.

Blood tests

Your healthcare professional may need to test your blood to make sure you have enough platelets. Platelets are blood-clotting cells. If you don't have enough of them, you may have an increased risk of bleeding. Medicine or a blood transfusion can increase the number of platelets in your blood.

Imaging tests

Your healthcare professional might recommend imaging tests to create pictures of your veins. Imaging tests such as X-rays or ultrasound can help with planning the procedure.

A discussion of your other health conditions

Tell your healthcare professional if you've had breast removal surgery, also called mastectomy. It's also important to tell your healthcare professional about any history of heart conditions, or if you have a heart device with wire leads, such as a pacemaker. Breast removal surgery or a pacemaker may affect which arm is used for the PICC line. Also let your healthcare professional know about previous arm surgeries, injuries, serious burns or radiation treatment.

If you have a history of kidney disease, tell your healthcare professional. An arm PICC line generally isn't recommended if there's a chance you may one day need dialysis for kidney failure. But you may be able to have a PICC line placed in other veins, such as a vein in your neck.

What you can expect

A healthcare professional inserts a peripherally inserted central catheter, also called a PICC line. The health professional can do this as an outpatient procedure, meaning it won't require a hospital stay. It may be done in a procedure room that's equipped with imaging technology, such as X-ray machines. That's because imaging can help guide the procedure.

It also may be done in a hospital room if you're staying in the hospital.

During PICC line insertion

During the PICC line insertion you lie on your back with your arm extended to your side. You are awake during the procedure. Numbing medicine is used to minimize pain.

A PICC line is usually inserted in a vein in the upper arm, above the elbow. Which arm is used depends on your particular situation, but usually the nondominant arm is used.

The healthcare professional may use an ultrasound machine to assess the veins in your arm. This is to make sure they're healthy enough to use for the PICC line. You might have a cuff tightened around your arm so that your veins stand out.

Once a suitable vein is found in your arm, the skin around the area is cleaned and prepared. The numbing medicine is injected into the skin.

To place the PICC line, the healthcare professional puts a needle through your skin and into the vein in your arm. Ultrasound or an X-ray might be used to confirm the placement. A small incision is made in the vein so that a thin, hollow tube can be inserted. This tube is the catheter.

Once the catheter is in your arm, it's carefully moved forward along the vein. The catheter continues up your arm and toward your heart.

When the catheter reaches the right location, you might have an X-ray to verify it is in place. If the procedure is being done in a hospital room, the healthcare professional might use a heart monitoring device to make sure the catheter has reached the correct location. You might have an X-ray later.

The other end of the catheter sticks out of your arm. A cap is placed over the end of the catheter to keep it free of germs. It may be taped down so it won't get in the way of your daily activities.

After PICC line insertion

After a PICC line insertion, there may be some tenderness and bruising in the area where the catheter enters the arm. It should go away within a few days.

As you adjust to life with a PICC line, you'll need to consider:

• PICC line protection. Your healthcare team may recommend specific ways to protect the arm with the PICC line. For instance, don't lift heavy objects and don't have blood pressure readings taken on the affected arm. Your care team might tell you to avoid jarring activities with your arm, such as throwing a ball. Avoid submerging the PICC line in water, such as might happen with swimming or using a hot tub.

• PICC line care. You are likely to receive care instructions for your PICC line. This might involve checking the area daily for signs of infection and flushing the line with solution weekly to keep it clear of clogs. It's easier if you have someone to help you with PICC line care. If you need help, you might consider hiring a home healthcare professional.

• PICC line covers. You'll need to cover your PICC line when you take a shower, as the area shouldn't get wet. Your healthcare team might provide a cover, or you can purchase one at a drugstore.

Results

A peripherally inserted central catheter, also called a PICC line, is kept in place for as long as you need it for treatment.

PICC line removal

A PICC line can be taken out when treatment ends. To take out the line, a healthcare professional gently pulls on the end of the catheter.

PICC line removal reduces your risk of complications, such as infection. But if there's a chance you may need a PICC line again, your care team may recommend keeping it in place.

Sources: Mayo Clinic — “Peripherally inserted central catheter (PICC) line"