Peripherally Inserted Central Catheter (PICC)

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Peripherally Inserted Central Catheter (PICC)

It has been recommended that you have a peripherally inserted central catheter (PICC). This is a thin flexible tube that is inserted into a vein. The PICC is inserted into your upper arm (above the elbow) and then threaded up the vein so that the tip lies in one of the large veins in your chest. It can remain in place for up to one year.

A specially trained doctor or advanced practitioner radiographer will insert your PICC. Not all patients are suitable for a PICC so the Practitioner/Doctor who will insert the PICC will assess your veins for suitability.

A PICC is ideal for people who;

  • Have small peripheral veins which are difficult to find or access.
  • Are very anxious about needles.
  • Need treatment such as chemotherapy long term antibiotics or regular venepuncture.

A PICC can be used to give you chemotherapy, fluids, antibiotics or other drugs directly into your blood stream. It can also be used for taking blood samples.

This leaflet explains some of the benefits, risks and alternatives to the procedure. We want you to have an informed choice so you can make the right decision. Please ask your medical team about anything you do not fully understand or want to be explained in more detail.

We recommend that you read this leaflet carefully. You and your doctor (or other appropriate health professional) will also need to record that you agree to have the procedure by signing a consent form, which your health professional will give you.

Benefits of the procedure
The aim of the procedure is to insert a central catheter through an arm vein in order to safely administer drugs over a period of time and/or enable blood to be drawn for tests. 

Serious or frequent risks      
A PICC is generally considered to be safe, but occasionally there can be complications. These include:

  • risk of infection in the skin or vein;
  • thrombosis (clotting) of the vein;
  • blockage of the catheter;
  • incorrect position of the catheter tip;
  • migration of the catheter
  • Irregular heart rhythm during insertion.
  • Rarely the placement of any long term catheter can cause narrowing/blockages in the central veins

You will be cared for by a skilled team of healthcare professionals who are involved in this type of procedure every day.

Other procedures that are available
There are other ways of administering drugs, for example, by injection. If you are receiving a long course of treatment the PICC will have been recommended to avoid the need for numerous injections.

Preparation before your procedure
Tell your doctor or nurse if you have previously had an allergic reaction to any local anaesthetics.

You may continue to eat and drink as normal before your procedure.

Your normal medicines
Continue to take your normal medicines up to and including the day of your investigation. If we do not want you to take your normal medication, your consultant will explain what you should do.

During your procedure
The line will be placed under ultrasound guidance and you will have a small injection of local anaesthetic. You will need to lie down while your PICC is inserted. The correct position of the catheter will be confirmed with x-rays during the procedure.  The procedure should take approximately 20 to 30 minutes.

The PICC will be held in place with a small anchoring device and covered with a clear, waterproof dressing.

You will be asked if you can bend your arm without any discomfort.

After your procedure
If you have any tenderness or pain in your arm, it may help to take a simple painkiller such as paracetamol – if suitable for you (follow the instructions on the pack). Aftercare will be discussed further with yourself in Rowan Suite following your procedure.

Looking after your PICC
Sometimes you may have some tenderness, swelling or inflammation of the upper arm where the PICC was inserted. This reaction is common in the first week after insertion. To minimise these reactions, apply warm compresses for 20 minutes three or four times a day for 2 days. 

If you are in hospital, the nursing staff will look after your PICC. This involves;

  • Cleaning the entry site and applying a new dressing (weekly); and
  • Flushing the line to prevent blocking when it is not in use (we do this as a minimum once a week).

If you have been discharged from hospital following your procedure, a district nurse will be arranged by Rowan Suite to attend to your PICC.

If you are worried about any aspect of your PICC or its appearance, please contact the ward or day unit for further advice (see ‘contacts’ section of this leaflet).

If you have any of the following, please contact the hospital straight away.

  • If you have a temperature above 38°C, chills or feel generally unwell. This could be the beginning of an infection.
  • Oozing from around the skin entry site of the line.
  • Cracks or leaks in the line.
  • Pain, redness or swelling around the site, in your neck or arm.
  • If your PICC becomes dislodged.

Personal hygiene
We encourage people with PICC lines to take a shower. This is preferable to submerging your PICC in bath water because of the risk of infection. Waterproof coverings are available for you to purchase to protect the line whilst showering. If you would like to know more about this, please speak to a member of staff.

Social Life
Having a PICC in place should not interfere with your social life. However, sports such as swimming, tennis, golf or vigorous gym exercises are discouraged as there is a risk your PICC could become dislodged because of excessive arm movement. However, there are many other activities that are acceptable. If in doubt, ask your doctor or nurse.

Contact details
If you have any specific concerns that you feel have not been answered and need explaining, please contact the following.

For chemotherapy patients:
Rowan suite (Oncology, WRH):                            via switchboard 01905 763333

Garden Suite: (Oncology Alexandra hospital)       via switchboard 01527 503030

For all other patients:
Contact your community / district nurse or GP

Other information
Do not forget advice, encouragement and support from staff is always available.

We have addresses and telephone numbers for support groups, and other useful booklets and information.

The following internet websites contain information that you may find useful.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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