Question

How do you access a PICC or central line?

Answer 1

PICC or peripherally inserted central catheter, is a form of intravenous access or long IV line that can be used for prolonged period of time or for administration of substance that should not be done peripherally. In general for long term intravenous antibiotic, nutrition , medications or for drawing blood.

PICC is a thin , long ,soft , flexible catheter .It is typically inserted in to antecubital floss and then threaded in to central circulation. PiCC lines are frequently flushed with heparin to maintain latency. So it is essential to aspirate 5 ml blood from line prior to use. It should be drawn freely. If the blood does not comes freely, di not use the catheter. Also flush the line with normal saline.If line does not flush ,then donot use catheter for access.Administer medication .IV maintenance fluid must be administered to keep line open during transport.

PICC should not be administered in a syringe less than 10ml as small syringes generate too much pressure and damage catheter. Flow rate through catheter should be maintained. Ensure all lines are secure before starting. PICc line access patients central circulation and risk factors are high.

Indications -

• immediate vascular access in life threatening emergency
• PiCC line access may be considered prior to peripheral IV placement, if it is doubtful.
• cardiac arrest, altered mental status.
• hypovolemia