Peripherally Inserted Central Catheter (PICC)
- Interventional Radiology
About this procedure
This guide provides information about a Peripherally Inserted Central Catheter (PICC) procedure. It includes details about what is involved, how to prepare and what to expect during and after the procedure. Please use this in addition to information from your doctor and nurse.
A PICC insertion is performed in an interventional radiology suite at IntraCare in Epsom. Your interventional radiologist will be assisted by our team of nurses and other highly skilled personnel.
What is a PICC procedure?
A PICC is a long, thin tube (catheter) that is inserted through a vein near your elbow and passed through to the largest veins near the heart. A PICC line requires careful care and monitoring, including signs of infection and blood clots.
Why a PICC is required?
PICC can be used for taking blood samples, nutritional feeding, long term IV medications, or chemotherapy.
Before the procedure
Pre-procedure phone call
A nurse from IntraCare will call you 24–48 hours prior to your procedure to discuss the following information:
- Your admission time.
- When you should stop eating and drinking.
- Medication instructions.
- Allergies (including medications, contrast dye, dressings/plasters and food).
- Answer any further questions.
Fasting instructions
To ensure your safety during the procedure, it is important that you follow the fasting guidelines below:
Food – Stop 6 hours prior to procedure. Do not consume any of the following within 6 hours of your planned procedure time:
- Solid food
- Milk-based products
- Soluble fibre
- Jelly
Fluids – Clear (transparent) fluids are encouraged up to 2 hours before your planned procedure time. These include:
- Water
- Clear juices
- Cordials
- Black tea or coffee
Avoid fluids containing milk, pulp, or jelly.
Sip-Til-Send (STS) Protocol*
- Unless advised otherwise, you can sip up to 200ml of water per hour in the 2 hours before your planned procedure time.
* Your nurse will confirm during your pre-procedure phone call whether this protocol is suitable for you.
Anticoagulation (blood thinner)
If you are taking any blood thinners (e.g. Warfarin, Clexane, Pradaxa, Rivaroxaban), please make this known to IntraCare staff at the time of booking. Your interventional radiologist or vascular surgeon will advise you if you need to stop this medication temporarily for a few days before the procedure.
Other regular medications
Please continue to take these unless advised otherwise by your interventional radiologist or surgeon. If you are taking a diuretic or water pills (e.g. frusemide, spironolactone), you may need to withhold this on the morning of the procedure. It is important that you let us know if you are taking the following medications: Liraglutide (Victoza™, Saxenda™) Dulaglutide (Trulicity™), Semaglutide (Ozempic™, Wegovy™), Tirzepatide (Mounjaro™).
Reminders for the day of your procedure
- If you are on regular medication, please bring this with you in its original packaging.
- Please leave all your jewellery and valuables at home. You are welcome to bring your mobile phone with you.
- We recommend wearing loose-fitting clothing and shoes that are easy to slip on/off.
- You are encouraged to bring a friend or a family member as a support person before and after your procedure.
- The planned procedure time is an estimate only and may vary. We will keep you informed of any unexpected delays on the day.
Informed consent
As with any procedure, there are potential risks involved. Your interventional radiologist will explain the procedure, discuss possible risks and answer any questions you may have. Your whānau or support person are welcome to be part of this discussion. You will then be asked to sign the consent form. This will occur either at an earlier appointment or on the day of your procedure.
Your procedure
A PICC insertion procedure usually takes 45–60 minutes.
Preparation
If necessary, we may need to remove hair with clippers at the access site for sterile preparation. Please avoid shaving the area yourself as this may cause minor abrasions to the skin, increasing the risk of infection.
The procedure
The area around the vein in your arm will be painted with an antiseptic solution, and a sterile drape will then be placed over your body, to ensure sterility is maintained. Local anaesthetic will be injected around the vein which will sting for approximately 30 seconds, but after this, you should not feel any pain. If at any time you feel pain, or discomfort, please inform the doctor immediately, and more local anaesthetic can be given.
Using ultrasound guidance, the best vein in your upper arm is selected. A PICC line catheter is then inserted into the vein, through the upper arm, around the shoulder and down towards your superior vena cava (largest vein in your heart). The catheter is secured with a dressing on your arm to ensure it remains in place and does not move. The sterile dressing also protects the site from infection. The PICC line can be used immediately following placement.
After your procedure
After the procedure you will be taken to IntraCare recovery where you will be given something to eat and drink, followed by which you will be discharged. Before you leave, a nurse will give you discharge instructions to follow at home.
Recovery and discharge
Following the procedure you may have some tenderness, bruising or discomfort at the incision site. This is usually managed with oral pain medication such as paracetamol. The discomfort should settle after 1–2 days.
Exercise/movement
- Do not do any exercises that involve forceful reaching or stretching.
- Avoid participating in any strenuous exercise such as golf, tennis, swimming, or aerobics while you have the PICC line.
- It is important not to lift your arm above shoulder height or lift any heavy objects (>5kg) for 2 weeks.
Follow-up
This will usually be with your oncology specialist or practice nurse, but you are welcome to contact IntraCare with any questions.
Procedure site care
Please keep the dressing in place until your oncology nurse removes it. If you have sensitive skin or a sensitivity to dressings, please inform the nurse so we can arrange an alternative.
The goal of procedure site care is to reduce the risk of contamination and infection. The dressings supplied are water resistant but not waterproof.
Please:
- Avoid baths, spas or swimming while the wound is healing.
- You can shower, but please place a plastic bag covering the site.
Following the procedure, please check the area around the PICC regularly. Contact your Oncology team if you have any of the following:
- Swelling
- Bleeding
- Redness
- Leaking of fluid or pus
- Pain
- Temperature greater than 38.5 degrees
- Arm swelling
- Extensive bruising
When the PICC is not being used, it is accessed and flushed once a month to make sure it does not get blocked. This will need to be organised with your oncology nurses.
To look after your PICC, please:
- Make sure the PICC dressing stays dry.
- Notify a health professional should the PICC site become red or painful.
- Take your PICC patient card with you to appointments.
Seek immediate medical attention (dial 111 for an ambulance) if there is excessive bleeding from the puncture site or if you are experiencing severe chest pain.
If you have any concerns, please contact IntraCare:
In case of emergency, always call 111.
FAQs
Who do I contact if I have concerns following the procedure?
If you have concerns in the first few days, contact your interventional radiologist, vascular surgeon, or a nurse at IntraCare.
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