After the PICC line is placed, it will be covered to keep it secure and clean.One end of the catheter will be near the heart the other end will be outside the skin. The catheter will stay in place inside the vein. When the catheter is in the correct position, the guide will be removed.The PICC line is then cut to the appropriate length and inserted over the guide wire until the tip of the catheter stops in the superior vena cava near the heart. The guide wire is used to measure the required length of the PICC. Using ultrasound or fluoroscopy guidance, a guide wire will be carefully moved up through the vein toward the heart. Once the area is numbed, a needle will be inserted into the vein in the arm.The medicine may sting for a few seconds. Then, the area will be numbed using a local anesthetic to reduce pain. This helps keep the area clean and prevent infection. A blue paper drape will also be used to cover the patient’s body except for the area of the arm. Usually, the patient will need to change into a gown. The care team will wear gowns, masks, and gloves.A cold gel is used so that the machine can get a clear picture. This will feel tight but should not hurt, and it will be removed after the imaging. During the ultrasound, a rubber band is tied around the arm so that the vein is easier to see. The patient will lie down on the treatment table. Ultrasound imaging will be used to locate the vein.Children who are not sedated may be allowed to listen to music or watch videos during the procedure. Some children will receive anesthesia so that they are asleep during the procedure.A parent may be able to stay in the room, depending on medical center policies. The procedure may be done in a treatment room or in the child’s hospital room.Members of the care team will meet with the family to complete paperwork and answer questions. Before PICC line placement, patients will have blood work and a physical exam.The total time for the procedure can be 1-2 hours with anesthesia and recovery. The actual placement of a PICC line usually takes about 15-30 minutes. It is very important to follow these guidelines. Patients who receive general anesthesia will be given NPO instructions for limiting food and drink before the procedure. Younger children may be given medicine to help them sleep or relax during the procedure. Many patients are awake during the procedure to insert a PICC line. Be sure to ask questions and follow all instructions given by the care team. Serious complications are rare, but they do occur. The main risks during insertion include puncture of a blood vessel, blood clots, irregular heartbeat, nerve injury, and infection. After line placement, blood clots, movement of the catheter out of position, vein inflammation, and infection are the most common complications. There are always risks involved with anesthesia and surgery. A PICC line can be removed in the clinic.A PICC line can often be used to give medication at home, making it easier for patients and families to continue therapy.
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