2. 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
3. Long 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
4. 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.
5. 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.
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.
6. 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:
7. 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.
15. 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.
