What is a PICC line?
A PICC line (peripherally inserted central catheter) is a long, flexible tube inserted into a vein on the upper arm. It is designed to reach the superior vena cava, a large vein near the heart which allows us to give parenteral nutrition, blood products, fluids, antibiotics and chemotherapy easily. All that you will be aware of is a small length of line externally, protruding from your arm. The line will have one or two cavities within the tube and, since it can be used to take blood, it will reduce the need for repeated injections.
What is a Midline?
A Midline is flexible tube inserted in to the upper arm about 10cms in length which allows us to give blood products, fluids and antibiotics easily. All that you will be aware of is a small length of line externally, protruding from your arm. The line will have one or two cavities within the tube and, since it can be used to take blood, it will reduce the need for repeated injections.
What happens when the line is inserted?
- The line will be placed by one of the nutrition nurses or a healthcare professional competent in placing lines. You will be given the opportunity to discuss the procedure and ask any questions you may have. You will then be asked to sign a consent form.
- The nurse will locate your vein using an ultrasound scanner and will inject a small amount of Lidocaine 1% w/v solution for injection (local anaesthetic) to numb the insertion site. This may cause a small amount of discomfort for a few moments only. A needle and “introducer” are then inserted, through which the PICC or Midline is threaded and secured in place.
- The ultrasound equipment used to locate the vein also uses an ECG trace to ensure that the PICC line is in the correct position. Occasionally it is necessary to have a chest X-ray instead.
- A dressing will be placed over the line entry site, which will need to be changed the next day. The whole process will take approximately two hours.
Caring for your line
You may feel discomfort around the entry site for the first few days following insertion. You may find it helpful to take a pain relief tablet such as Paracetamol. Placing a warm flannel or covered hot water bottle around the top of your arm for twenty minutes every four hours for the first four days may be beneficial, as it will help to prevent your veins becoming irritated by the line. If the pain is severe or your arm becomes red, hot or inflamed, please inform the medical staff. You must also tell us of any leaking or swelling around the line of entry. If you develop a raised temperature above 38 degrees Celsius, you may be developing an infection and should seek medical advice immediately.
- Your PICC line will need to be flushed with saline solution weekly
- Your Midline will need to be flushed with saline solution daily
How will my line be removed?
Once the need for the line is no longer indicated your line will be removed. We will do this by gently pulling the tube back through the entry site on your arm. Normally this is not painful, but sometimes may be slightly uncomfortable. We do not need to numb the area for this procedure. A dry dressing will be applied which you may remove after 48 hours.
Please feel free to contact us with any other questions or concerns you may have.
Office number: 01935 384250
Nutrition Nurses: 01935 606102 or 01935 606103
