While having a central catheter inserted may sound overwhelming, it's actually a virtually painless procedure—one that will help you to feel better by ensuring safe delivery of the medications you need.
Review our list of frequently asked questions about Peripherally Inserted Central Catheters (PICC) or Midline Catheters (MLC) for more information.
Questions about PICCs
Where will this procedure happen?
Will I feel the long catheter as it travels into my vein?
How will the nurse know it is in the right place?
What are the risks of getting a PICC placed?
Can I go home with a PICC line in place?
What can I do to care for the PICC?
Can I take a shower with the PICC in place?
Will I have the PICC for a long time? How do you take it out?
What is a PICC?
PICC stands for Peripherally Inserted Central Catheter. Your
doctor has requested that you have one of these catheters placed to ensure the
safe delivery of the medications you need. Before you have a PICC placed, your
infusion nurse or physician will answer any questions you may have and ask you
to sign a consent form.
What does a PICC look like?
A PICC is a long, soft, flexible catheter that is placed by
specially trained nurses. The catheter starts in a vein between the elbow and
the shoulder and then follows that vein to a large vessel in the chest called
the superior vena cava. You will have a sterile dressing on your arm and one or
two short extensions where your nurse will infuse your medication and/or draw
blood.
Where will this procedure happen?
Most likely the entire procedure will take place in your
hospital room. Your infusion nurse will assess your veins either by palpation
(touch) or by ultrasound. The ultrasound is a painless device that helps locate
veins that are deeper in your arm using sound waves. If the infusion nurse
feels that the PICC cannot be placed in your room, he or she will make
arrangements for the procedure to take place in Interventional Radiology.
Will I be awake for this?
Yes. The procedure takes between 30 and 45 minutes. The only
discomfort you will feel is the numbing of the site with lidocaine. Lidocaine
is injected into the skin using a very small needle. This will numb the tissue
so you won't feel the IV catheter being inserted.
Will I feel the long catheter as it travels into my vein?
No. The inner layer of your vein does not have nerves, so
the small soft catheter just floats along with the blood back towards the
heart. Your infusion nurse will measure and cut the catheter prior to insertion
so that it stops in the right place.
Why do I need a PICC?
The small veins in your arms and hands are good for
short-term, mild medications and fluids. Your physician may have determined
that you need a PICC because of the strength of the medication prescribed, the
length of time you will need the medication, the availability of veins in your
arms and hands, the need for frequent blood samples or a combination of these
things.
How will the nurse know it is in the right place?
Your infusion nurse has been trained to measure from the
point where he or she plans to insert the PICC to the area on your chest that
lies over the superior vena cava. The target area is approximately 3 inches (7
cm) long. To confirm where the tip is located, an X-ray will be taken in your
room or in the radiology department. If you are pregnant, please inform the X-ray
technician to cover your abdomen.
What are the risks of getting a PICC placed?
Any time you have a needle inserted into your skin there is
a risk of infection. This is why your infusion nurse will take time setting up
a sterile area and cleansing your skin. After the PICC is placed, we encourage
you to use that arm as you normally would. This will help decrease the chance
of a blood clot forming in the vein by increasing the blood flow around the
catheter.
Most people will have a little bleeding at the insertion site, so your infusion nurse will place a small piece of gauze under the clear dressing for 24 hours. Some people have more significant bleeding and may need the dressing changed a few times. Unsuccessful insertions do happen occasionally. Due to your unique situation, the soft, flexible catheter may not be able to reach its destination. On extremely rare occasions there could be an equipment failure that makes first attempts at insertion unsuccessful. Your physician, primary nurse and infusion nurse will be monitoring your PICC for any complications.
Will my arm hurt tomorrow?
Probably not. Most people do not have arm pain after
placement of a PICC. Few people, maybe one in twenty, experience
mild-to-moderate soreness in their upper arm. This is most likely caused by
venospasm. This is when the muscle layer of your vein tightens around the
catheter. It is most often relieved by applying warm compresses around your
upper arm to relax the vein. It feels like a muscle that has had a workout.
This can happen anytime from 12 hours after insertion to a week later. Usually
applying warmth to the area relieves the spasm and the soreness goes away.
Can I go home with a PICC line in place?
Yes. If your physician decides you need to receive IV
medication at home, you can go home with your PICC line. A nurse called a
Discharge Planner will assist with setting up healthcare services to care for
your PICC after you leave the hospital. Most patients have it taken out before
they leave the hospital.
What can I do to care for the PICC?
Let your nurses know if you notice any of the following:
pain or tenderness in your arm, redness around the insertion site, drainage,
bleeding, swelling in the arm with the PICC, pain with fluids infusing, or
change in heart rhythm.
In addition, let your nurse know if the dressing on your PICC is coming off or if you feel like there is moisture under the bandage. Let your nurse know immediately if you think the PICC is starting to come out. Do not push the PICC back in. Please also be sure to view our informational brochure "Protect that PICC."
Can I take a shower with the PICC in place?
Yes. If you have no other restrictions for taking a shower
or bath, your PICC will not prevent you from bathing. You will need to be
careful not to soak the dressing with water. Ask your nurse for assistance with
how to cover the dressing to minimize exposure to water. If moisture gets under
the dressing let your nurse know so it can be changed quickly.
Will I have the PICC for a long time? How do you take it
out?
Most people have their PICC between one to four weeks,
depending on the therapy. When your physician determines that it is no longer
needed, a trained nurse will remove the PICC. Removing your PICC is a simple,
quick procedure performed in your room. The most uncomfortable part of removing
a PICC is taking off the dressing. It usually slides out without your
knowledge.
Midline Catheter Questions
Where will this procedure happen?
Will I be awake for this procedure?
Will I feel the long catheter as it travels into my vein?
What is the biggest difference between a PICC and a MLC?
What are the risks of getting a MLC placed?
What is a MLC?
A MLC is a midline catheter that starts in a vein between the elbow
and the shoulder and follows the vein to an area just below the arm pit.
What does a MLC look like?
A MLC is a long, soft, flexible catheter that is placed by
specially trained nurses. When the nurse is finished, you will have a clear
dressing on your arm with one short extension that will allow your nurse to
infuse your medications and draw blood samples for tests.
Where will this procedure happen?
Most likely, the entire procedure will take place in your
hospital room. Your nurse will assess your veins either by palpation (touch) or
by ultrasound. The ultrasound is a painless device that aids in locating the
veins that are deeper in your arm using sound waves.
Will I be awake for this procedure?
Yes. The procedure takes between 30 and 45 minutes. Probably
the most discomfort you will feel is the numbing of the insertion site with
lidocaine. Lidocaine is injected into the skin using a very small needle. This
will numb the tissue so you won't feel the IV catheter being inserted.
Will I feel the long catheter as it travels into my vein?
No. The inner layer of your vein does not have nerves, so
the small, soft catheter just floats along with the blood back towards the
heart. Your infusion nurse will measure and cut the catheter prior to insertion
so that it stops in the right place.
Why do I need a MLC?
The small veins in your arms and hands are good for
short-term, mild medications and fluids. Your physician may have determined
that you need a MLC because of the length of time you will need the medication,
the availability of veins in your arms and hands, the need for frequent blood
samples or a combination of these things.
What is the biggest difference between a PICC and a MLC?
The biggest difference is where the tip of the catheter is
located. A PICC tip is located in the superior vena cava and will allow all
types of medication to infuse safely. The MLC tip is located in a large vein,
but because it is not in an area where medication can be diluted quickly, there
are limitations to what can be delivered through this catheter.
What are the risks of getting a MLC placed?
Any time you have a needle inserted through your skin there
is a risk of infection. This is why your infusion nurse will take so much time
setting up a sterile area and cleansing your skin. After the MLC is placed, we
encourage you to use that arm as you normally would. This will help decrease
the chance of a blood clot forming in the vein by increasing the blood flow
around the catheter.
Most people will have a little bleeding at the insertion site, so your infusion nurse will place a small piece of gauze under the clear dressing for 24 hours. Some people have more significant bleeding and may need the dressing changed a few times. Unsuccessful insertions do happen occasionally. Due to your unique situation, the soft, flexible catheter may not be able to reach its destination. On extremely rare occasions there could be an equipment failure that makes first attempts at insertion unsuccessful.
How long will I have the MLC?
Midline catheters are great for certain situations, but they
do have limitations. With a few exceptions, a Midline should not be in your arm
for more than four weeks. The fibrin that forms around the MLC can cause the
fluid to leak out of the small hole in your skin. If this happens, please let
your nurse know as soon as possible.
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