PICC Line Placement in Lucknow

A PICC, short for peripherally inserted central catheter, is a long, thin, soft tube. It goes in through a vein of the upper arm and is passed along the vein until its tip lies in a large vein close to the heart. The other end stays outside the arm, usually with one or two small caps.

Strong medicines, including many chemotherapy drugs, can irritate the small veins of the arm. In a large central vein they are diluted quickly. The same line can be used for weeks or months, so you are spared a needle each time.

A PICC line is used when treatment needs reliable access to a central vein for weeks or months. Doctors may advise it for the following.

• Chemotherapy, especially cycles that run over several months.
• Long courses of intravenous antibiotics, for example for a bone or deep-seated infection.
• Intravenous feeding or other drugs that irritate small veins.
• People whose arm veins are hard to find and who need weeks of intravenous treatment.

It is not the right line for everyone. A short course can be given through an ordinary cannula or a midline catheter. Treatment lasting many months or years may suit an implanted port or a tunnelled central line better. Your treating doctor makes that choice.

Placement is done under ultrasound guidance, with local anaesthetic to numb the skin of the upper arm. A band is tied around the arm and ultrasound is used to pick a suitable vein. The vein is entered with a small needle, a guide wire goes in, and the line follows it.

The tip position is checked, either on an X-ray or by another tip-guidance method, before the line is used. A stitch or a special sticker holds the line in place, and a clear dressing covers the site. The team carrying out the procedure explains the exact steps, since methods differ from place to place.

A PICC line stays safe when it is kept clean, dry and untouched except by trained people.

• Dressing: keep it dry and stuck down. A nurse changes it on a regular schedule, often once a week, and at once if it gets wet, dirty or loose.
• Flushing: the line is flushed with saline, and sometimes a lock solution, as instructed, so that it does not clot. Do not flush it yourself unless you have been taught.
• Washing: cover the arm with a waterproof sleeve or plastic cover. Do not swim or soak the arm.
• The arm: use it for normal daily tasks. Avoid heavy lifting, pulling and strenuous exercise as advised, and do not wear tight sleeves over the line.
• Cuffs and needles: no blood pressure cuff, injections or blood draws on that arm unless the treating team says it is fine.
• Hands: wash them before touching near the site, and keep children and pets from tugging at it.

Look at the site and arm every day. If more of the tube is showing than when it was placed, it may have slipped.

A PICC line spares you repeated needle sticks, but like any line it carries risks. It gives access for treatment and does not treat the illness itself.

• Infection of the exit site or the bloodstream, the most important risk. The warning signs are listed below.
• A clot in the arm vein around the line, which shows as swelling, pain or heaviness in the arm.
• A blocked line that cannot be flushed or drawn from.
• A slipped line, or a tip that has moved from its position.
• Bruising, bleeding or pain at the site, and sometimes irritation of the vein.
• Rarely, puncture of a nearby artery or nerve, a disturbance of the heart rhythm during insertion, or air entering the line.

A PICC line may not suit you if you have kidney disease that could need dialysis, because arm veins may be needed for a fistula. It may also be avoided if there is an infection or clot in that arm. After breast surgery with lymph node removal, the arm on the operated side is usually avoided. The team asks about all of these.

Suitability depends on the treatment prescribed, the condition of your arm veins and your general health. A fever, an infection in the blood or a clot in the arm vein may mean the line has to wait. The doctor who treats you, such as an oncologist, physician or infection specialist, makes the request.

We review the request, your reports and any vein findings first. An arm vein ultrasound or Colour Doppler scan can show whether the veins are suitable and open, and the team confirms the exact scan when you book. After that review the team tells you whether the PICC line is placed at our centre or elsewhere, and who will do it. That is not decided in advance.