PICC lines
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What is a PICC line?
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What is a PICC line used for?
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How is a PICC line put in?
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Possible problems when putting in a PICC line
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Taking care of your PICC line
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Possible problems with a PICC line
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How a PICC line is removed
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About our information
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How we can help
What is a PICC line?
A PICC (peripherally inserted central catheter) line is used to give chemotherapy or other treatments.
A PICC line is a long, thin, hollow, flexible tube. A nurse or doctor will put it into one of the large veins of the arm, above the bend of the elbow. Then they will thread it along the vein until the tip is in a large vein just above the heart.
Sometimes the PICC line is made up of 2 or 3 fine tubes. These are joined as 1 tube inside the body and divide into 2 or 3 lines outside the body. This allows you to have different treatments at the same time. Each line is usually sealed with a special cap or bung. There may be a clamp to keep the line closed when it is not being used.
A PICC line
The end of a PICC line
What is a PICC line used for?
A PICC line can be used to give you treatments such as:
- chemotherapy
- blood transfusions
- antibiotics and other drugs
- intravenous (IV) fluids
- liquid food if you are not able to eat.
It can also be used to take samples of your blood for testing.
If you have a PICC line, you will not need to have needles put in every time you have treatment. This can be helpful if doctors and nurses find it difficult to get needles into your veins. It is also helpful if you do not like needles.
You can go home with the PICC line in. It can be left in for weeks or months.
How is a PICC line put in?
A doctor or specialist nurse will put in your PICC line at the hospital. It can either be done in an outpatient department or on a ward. They will talk with you about which arm would be better to use. They can also answer any questions you may have about the line.
Your doctor or nurse may use an ultrasound scan to help them find the best vein to use in your arm.
Then they will clean the skin with antiseptic solution in the area where the line will be put in. They will numb the area with an anaesthetic cream or injection. When the skin is completely numb, the doctor or nurse will put a needle into the vein.
They will gently thread the PICC line through the needle into a large vein that leads to the heart. They then remove the needle.
This should not take long and is usually painless. The end of the line comes out above the bend of the elbow. The PICC line will be held in place by a clear dressing.
You will have a chest x-ray to check that the end of the tube is in the right place.
Possible problems when putting in a PICC line
It is sometimes difficult to thread the PICC line up the vein towards the heart. If there is a problem, it is usually possible to try again using a different vein.
Sometimes, the PICC line seems to go in easily but the x-ray shows it is not in the right place. If this happens, your nurse or doctor may be able to move it. If that does not work, the PICC line will be taken out and replaced.
Taking care of your PICC line
When the PICC line is not being used, there is a slight risk of it becoming blocked. To stop this from happening, a small amount of fluid is flushed into the line using a syringe. This is usually done once a week.
The caps or bungs at the end of the line need to be changed each week to reduce the risk of infection. The dressing also needs to be changed every week. If it gets wet or starts to peel off, it should be changed sooner.
It is difficult to change the dressing with one hand, so the nurses at the hospital may do it for you or arrange for a district nurse to visit you at home. They can also teach a family member, partner or friend how to change the dressing.
When you are at home, it is safe for you to have a shower or bath with your PICC line in. Your nurse can give you waterproof covers to stop the line getting wet.
Possible problems with a PICC line
Infection
It is possible for an infection to develop inside the PICC line or in the area where it goes into the vein. Contact your hospital doctor or nurse if you have:
- redness, swelling or pain in the area
- discoloured fluid coming from the area
- a high temperature (fever).
If you get an infection, you will be given antibiotics. If the infection does not get better, the doctor may remove your line.
Blood clots
It is possible for a blood clot (thrombosis) to form in your vein at the end of the line. You may be given medication to help prevent this. Contact your hospital doctor or nurse if you have:
- swelling, redness or tenderness in the arm, chest area or up into the neck (on the same side as the PICC line)
- a swollen hand (on the same side as the PICC line)
- shortness of breath
- tightness in your chest.
If a clot does form, your doctor or nurse will give you some medication to dissolve it. Your line may have to be removed.
Blocked PICC line
The inside of the line can sometimes become partly or completely blocked. If this happens, it can be difficult to give treatment or to take blood tests through it. Your doctor or nurse may flush the line with a solution to try to clear the blockage, or it may need to be removed.
Air in the PICC line
It is important not to get any air into your PICC line. Not all PICC lines have clamps. Some lines have caps at the end that stop air from getting into the line. If your PICC line has a clamp, it should always be closed when the line is not being used. The line must not be left unclamped when the caps are not in place.
Loose PICC line
A break or cut in the PICC line
It is important that the PICC line is not broken or cut. Do not use scissors near the PICC line.
It is not very common to get a cut or split in the line. If this happens, try to tie or clamp your line just above the break. This is to seal it between the split and where the line comes out of your body. Contact your hospital straight away. The line may need to be removed if it cannot be repaired.
How a PICC line is removed
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About our information
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References
Below is a sample of the sources used in our chemotherapy information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Brighton, D. Wood, M. The Royal Marsden Hospital Handbook of Cancer Chemotherapy. Elsevier Churchill Livingstone. 2005.
National Institute for Health and Care Excellence (NICE) Neutropenic Sepsis Guideline CG151. 2012.
Perry, MC. The Chemotherapy Source Book (5th ed.) Philadelphia: Lippincott, Williams & Wilkins. 2012.
UKONS Acute Oncology Initial Management Guidelines Version 3, March 2018. Available from www.ukons.org (accessed June 2021).
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.
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