Picc Line Essay
Do you need a PICC line? Does one of your family members or friends have one? Do you know what purpose they serve for? Do you need to learn how to take care of one? In this article, you will learn what a PICC line is, under what conditions you may need one, how to keep it safe, how to live with one day-to-day, and how to care for a PICC line.
What is a PICC Line?
A PICC line stands for Peripherally Inserted Central Catheter (Treatments & Procedures, 2015). What this means is that a PICC line is tubing running into a vein that is in your arm. This tubing is called cannula; it is flexible, soft, small in diameter and thin. It may be uncomfortable when first inserted, but once it is in place, it should not be painful. That patient will just have to be careful with it to ensure that the cannula does not come out (Treatments & Procedures, 2015).
Why do you need one? …show more content…
The purpose of a PICC line is for IV medications for treatment and frequent laboratory blood tests.
The patient will be receiving long term medicine through this line. The medicine could be for anything like pain, infection, cancer, or maybe for someone who needs nutrients. Because this line goes directly into the heart, it is distributed through the body quickly letting the medicine or IV fluids go to work immediately in the patient. A PICC line is also for patients that may need a quick blood infusion. For a patient that is always having blood tests done, this PICC line is an advantage because they won’t get poked with a needle but one time when originally inserting the line. Another reason a patient may need this treatment is because they have renal failure and need to receive dialysis. For some of these patients that are sent home from the hospital, a PICC line allows them to have IV medicines and fluids at home with proper training and teaching (Central Venous Catheters-Topic Overview,
2015).
How is it inserted? Peripherally inserted central catheters can be tricky, so that is why it takes a trained nurse or doctor to insert one. They will use an ultrasound machine on the patient’s arm to help them find the vein they want. Then, they will clean the arm well. There will be a sterile cloth that goes over the arm next to it to help prevent infection. After medicine will be applied to numb that area of the arm. The vein that the catheter will insert is a large vein called your Subclavian vein, and it is slightly above the elbow. Once the PICC is in, it will be advanced into the chest and into the heart. When it is done being inserted, that means it is sitting in the Superior Vena Cava. Next, the line will have a tape dressing applied over the site where it was inserted. Then, an x-ray is taken afterwards to ensure its placement. The great thing about a PICC line is that the patient will be able to move their arm just like normal (Treatments & Procedures, 2015).
Safety
PICC lines are safe as long as they are checked on often. What to look out for is problems with the tubing. You want the tubing to be untangled with no kinks in it. With the tubing kinked, it can cause the medicine or IV fluids to not drip into the patient leaving that patient with no fluids. It is important to not pull on the catheter. It may happen by accident; if this is the case, then it should be replaced. The nurse should be notified immediately. A safety key as well is to watch for infection at the site. If the skin is not its normal color, if skin is cold or hot to the touch or maybe it has rash near it, nurse and physician should be notified. If the patient sees crystals in the tubing or if it has a foggy color, call a nurse. The nurse will discontinue the line (PICC- Peripherally Inserted Central Catheter, 2011).
Staff members need to also pay attention to any allergy or adverse reactions to medication. If there is any air bubbles in the tubing, it should be removed. This air going into heart could cause a heart attack or stroke. It’s important to know the patient will be exposed to a lot of radiation due to all the x-rays they will have because the placement will need to be checked often (PICC- Peripherally Inserted Central Catheter, 2011). It is important to know when to call the doctor. Never hesitate because it is better to be safe than sorry. If a patient with a PICC line becomes unconscious, a caregiver should call 911. If the patient does not appear to have become unconscious, but has trouble breathing, chest pain, or blood coming up when they cough or has a fast pulse, then this is also an emergency situation. All of these things may happen if a patient has a PICC line in place. Also, call the doctor when you see any abnormalities in the line. This includes pain, red streaks near site, warmth, swelling, pus or blood, fever or swollen lymph nodes. Any signs of blood clotting, line leaking, or when the central line is not in its correct place, a medical professional should be contacted directly (Central Venous Catheters-Topic Overview, 2015).
Care
You can care for a PICC line by using different methods or techniques, but care instructions from the National Jewish Health seems to be effective. They say to apply a warm pack to the insertion site to be applied “for 30 minutes, every 2 hours for the first 24 hours” (Caring for Your PICC Line, 2016). Any kind of pain medication should be taken as your doctor is more than likely going to prescribe you one. This will help with soreness or inflammation. Also, it is important to keep the dressing dry. Consider taking a bath rather than a shower. Keeping the dressing dry will help it stay intact. A protector applied before you bathe would be ideal. No swimming or sitting in the hot tub if you have a PICC line in place. When a nurse goes to take your blood pressure, be sure she doesn’t do it on the arm where you have your line inserted. When you have a PICC line in place, you should be careful when lifting objects. You shouldn’t lift an object over five to ten pounds. If you do, be sure the line is still in place because it could come out when lifting (Caring for Your PICC Line, 2016).
Removal of PICC Line
The removal of the line is a rather easy part. The nurse will gather all of the supplies necessary. Hands will be washed and sterile gloves will be applied. Then, the procedure will begin. The nurse will explain to the patient what is going to happen. She will place the patient in a supine position which means they will be lying flat on their back. When the nurse is ready to remove it, the patient should take big deep breaths. After that a sterile piece of gauze will be applied and pressure is to be held on the sight until bleeding stops. Then, a Band-Aid will be applied over the sight. After the Band-Aid is applied, the patient may relax because the procedure is over. The nurse will document the date, time, and kind of line, and the condition of the tubing to ensure it was all still intact and how the patient responded to the procedure (PICC Line Removal | How to Remove a PICC Line, 2014).
Possible Complications after Removal There a quite a few of possible complications after removal, but remember they are possible, not always likely. One complication may be a hematoma or bleeding. This is why it is important to hold pressure on site after removal. When you have a dressing covering the hole where it was removed, it’s good to change it every day or every other day. Another complication may be that the catheter tip came off into the vein. If it goes into the superior vena cava, surgery will be required. This may happen because there was too much pressure put in the catheter when irrigating. A symptom of this may be discomfort. The nurse will know immediately after removal if the catheter tip is still in the body or not. If it was not, then that means it was still intact with the catheter (Earhart, 2013).
Conclusion
Peripherally inserted central catheters are a great therapeutic way to care for a patient that needs long term IV fluids, medications, and numerous blood draws. There are many benefits of the line, one of them including no needle sticks for blood draws. Also, you can have a line in your body anywhere (the hospital or at home.) It is important to be educated on the PICC line if you have one inserted. You should know how to care for it and when you need to call 911 or your physician.
What is a PICC Line?
A PICC line stands for Peripherally Inserted Central Catheter (Treatments & Procedures, 2015). What this means is that a PICC line is tubing running into a vein that is in your arm. This tubing is called cannula; it is flexible, soft, small in diameter and thin. It may be uncomfortable when first inserted, but once it is in place, it should not be painful. That patient will just have to be careful with it to ensure that the cannula does not come out (Treatments & Procedures, 2015).
Why do you need one? …show more content…
The purpose of a PICC line is for IV medications for treatment and frequent laboratory blood tests.
The patient will be receiving long term medicine through this line. The medicine could be for anything like pain, infection, cancer, or maybe for someone who needs nutrients. Because this line goes directly into the heart, it is distributed through the body quickly letting the medicine or IV fluids go to work immediately in the patient. A PICC line is also for patients that may need a quick blood infusion. For a patient that is always having blood tests done, this PICC line is an advantage because they won’t get poked with a needle but one time when originally inserting the line. Another reason a patient may need this treatment is because they have renal failure and need to receive dialysis. For some of these patients that are sent home from the hospital, a PICC line allows them to have IV medicines and fluids at home with proper training and teaching (Central Venous Catheters-Topic Overview,
2015).
How is it inserted? Peripherally inserted central catheters can be tricky, so that is why it takes a trained nurse or doctor to insert one. They will use an ultrasound machine on the patient’s arm to help them find the vein they want. Then, they will clean the arm well. There will be a sterile cloth that goes over the arm next to it to help prevent infection. After medicine will be applied to numb that area of the arm. The vein that the catheter will insert is a large vein called your Subclavian vein, and it is slightly above the elbow. Once the PICC is in, it will be advanced into the chest and into the heart. When it is done being inserted, that means it is sitting in the Superior Vena Cava. Next, the line will have a tape dressing applied over the site where it was inserted. Then, an x-ray is taken afterwards to ensure its placement. The great thing about a PICC line is that the patient will be able to move their arm just like normal (Treatments & Procedures, 2015).
Safety
PICC lines are safe as long as they are checked on often. What to look out for is problems with the tubing. You want the tubing to be untangled with no kinks in it. With the tubing kinked, it can cause the medicine or IV fluids to not drip into the patient leaving that patient with no fluids. It is important to not pull on the catheter. It may happen by accident; if this is the case, then it should be replaced. The nurse should be notified immediately. A safety key as well is to watch for infection at the site. If the skin is not its normal color, if skin is cold or hot to the touch or maybe it has rash near it, nurse and physician should be notified. If the patient sees crystals in the tubing or if it has a foggy color, call a nurse. The nurse will discontinue the line (PICC- Peripherally Inserted Central Catheter, 2011).
Staff members need to also pay attention to any allergy or adverse reactions to medication. If there is any air bubbles in the tubing, it should be removed. This air going into heart could cause a heart attack or stroke. It’s important to know the patient will be exposed to a lot of radiation due to all the x-rays they will have because the placement will need to be checked often (PICC- Peripherally Inserted Central Catheter, 2011). It is important to know when to call the doctor. Never hesitate because it is better to be safe than sorry. If a patient with a PICC line becomes unconscious, a caregiver should call 911. If the patient does not appear to have become unconscious, but has trouble breathing, chest pain, or blood coming up when they cough or has a fast pulse, then this is also an emergency situation. All of these things may happen if a patient has a PICC line in place. Also, call the doctor when you see any abnormalities in the line. This includes pain, red streaks near site, warmth, swelling, pus or blood, fever or swollen lymph nodes. Any signs of blood clotting, line leaking, or when the central line is not in its correct place, a medical professional should be contacted directly (Central Venous Catheters-Topic Overview, 2015).
Care
You can care for a PICC line by using different methods or techniques, but care instructions from the National Jewish Health seems to be effective. They say to apply a warm pack to the insertion site to be applied “for 30 minutes, every 2 hours for the first 24 hours” (Caring for Your PICC Line, 2016). Any kind of pain medication should be taken as your doctor is more than likely going to prescribe you one. This will help with soreness or inflammation. Also, it is important to keep the dressing dry. Consider taking a bath rather than a shower. Keeping the dressing dry will help it stay intact. A protector applied before you bathe would be ideal. No swimming or sitting in the hot tub if you have a PICC line in place. When a nurse goes to take your blood pressure, be sure she doesn’t do it on the arm where you have your line inserted. When you have a PICC line in place, you should be careful when lifting objects. You shouldn’t lift an object over five to ten pounds. If you do, be sure the line is still in place because it could come out when lifting (Caring for Your PICC Line, 2016).
Removal of PICC Line
The removal of the line is a rather easy part. The nurse will gather all of the supplies necessary. Hands will be washed and sterile gloves will be applied. Then, the procedure will begin. The nurse will explain to the patient what is going to happen. She will place the patient in a supine position which means they will be lying flat on their back. When the nurse is ready to remove it, the patient should take big deep breaths. After that a sterile piece of gauze will be applied and pressure is to be held on the sight until bleeding stops. Then, a Band-Aid will be applied over the sight. After the Band-Aid is applied, the patient may relax because the procedure is over. The nurse will document the date, time, and kind of line, and the condition of the tubing to ensure it was all still intact and how the patient responded to the procedure (PICC Line Removal | How to Remove a PICC Line, 2014).
Possible Complications after Removal There a quite a few of possible complications after removal, but remember they are possible, not always likely. One complication may be a hematoma or bleeding. This is why it is important to hold pressure on site after removal. When you have a dressing covering the hole where it was removed, it’s good to change it every day or every other day. Another complication may be that the catheter tip came off into the vein. If it goes into the superior vena cava, surgery will be required. This may happen because there was too much pressure put in the catheter when irrigating. A symptom of this may be discomfort. The nurse will know immediately after removal if the catheter tip is still in the body or not. If it was not, then that means it was still intact with the catheter (Earhart, 2013).
Conclusion
Peripherally inserted central catheters are a great therapeutic way to care for a patient that needs long term IV fluids, medications, and numerous blood draws. There are many benefits of the line, one of them including no needle sticks for blood draws. Also, you can have a line in your body anywhere (the hospital or at home.) It is important to be educated on the PICC line if you have one inserted. You should know how to care for it and when you need to call 911 or your physician.