PICC and Midline Catheters

 

PICC

A Peripherally inserted central catheter (PICC) is a small flexible tube that is inserted into a vein in your arm.  The PICC extends into the larger veins in your chest.  The catheter does not go into your heart. 

A PICC is used to give a patient medicines, fluids, and nutrients directly to the blood stream.  This is called intravenous (IV) therapy.  The PICC may stay in as long as you needed.

PICC’s are used for a variety of medical reasons including:

• Long-term intravenous access to veins

• Medicine given over several days, weeks, or months

• Long-term intravenous nutrition

• Frequent blood draws

When must a PICC line be Centrally located?

• When the PH of the medication being infused is less than 5 or greater than 9.

• When intravenous medications are considered venous irritants regardless of pH or concentration.

• When the osmolarity of an infusion or nutrient exceeds 850 mOsn/L.

 

Midline Catheter

A midline catheter is a small flexible tube that is shorter than a PICC line.  It is inserted to the same veins as a PICC line, but it only extends to a point just below your armpit.  It is not a central venous catheter

A midline catheter does not provide for ongoing blood access.  It cannot be used for certain medications. 

Midline catheters are used for patients who need:

• Short-term intravenous access to a vein, whose peripheral veins cannot handle repeated needle sticks

• Some types of medications given over several days to a couple of weeks

• Short term intravenous fluids

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Caring for Your Catheter at Home

These are the special things that you will need to learn:

• preventing infection

• flushing the PICC line

• giving the medicine

• solving problems

• knowing when and who to call for help

 

A nurse will teach you how to do all these things and will be available for questions.  Home health care nurses will also come to your home to change the catheter dressing.

 

Aseptic Technique

Germs (bacteria, virus, or fungus) can enter your body through the catheter.  This means that you will need to keep your hands and work surfaces clean (aseptic) when you handle your medications, catheter and IV tubing. 

The process you will use to clean your hands and work surface is called aseptic technique.  Aseptic technique means to disinfect or clean each part used and to avoid touching sterile surfaces with your hand.

Follow these steps every time you do your treatment:

• Wash your hands

  • Apply antibacterial soap to cover the entire surface of your hands.  Be sure to wash under your fingernails and in between your fingers

  • Dry your hands with a new, unused paper towel.  Do not use a cloth or other towel that can be reused.

  • Use paper towel to turn of faucet.

• Prepare your work area

Your work area should be away from family activity, small children, and pets.  Do not use the bathroom as a workspace because it is full of germs.

A sturdy washable surface makes the best work area.  Your work area should be free of drafts. 

 

Inspect Your PICC or Midline Catheter Every Day

Report any redness, swelling or drainage from your catheter to your home health nurse or doctor. 

 

Flushing your Catheter

The catheter must be flushed routinely so fluids will flow easily.  If the line becomes clogged it may have to be removed.  Your nurse will teach you how to flush your line and how to give medications. 

 

General PICC/Midline Care

• No strenuous activity or heavy lifting for the first 48 hours after line is placed.

• As much as possible, use your arm with the catheter.  This helps prevent blood clots.

• Never use scissors to remove tape/dressing from around the line.

• Always tape the line to your arm to prevent snagging on objects

• Cover with plastic when showering so the dressing does not get wet.  Do not let ends of line hang in any water.

• Swimming and submersion in water are not allowed.

• Change dressing and cap every 7 days.

• No rough or contact sports as line might move or be damaged.

• To avoid damage to line, do not use pins, sharp clamps, or scissors near you line.

• Avoid dental work.  If dental work is necessary, tell the dentist at least 5 days before the dental work. 

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