|Peripherally inserted central catheter (PICC) insertion using image guidance||1012.00000000000||Peripherally inserted central catheter (PICC) insertion using image guidance||Peripherally inserted central catheter (PICC) insertion using image guidance||P||English||Other||Child (0-12 years);Teen (13-18 years)||NA||Cardiovascular system||Procedures||Caregivers
Adult (19+)||NA||2019-07-25T04:00:00Z||9.00000000000000||61.5000000000000||1293.00000000000||Health (A-Z) - Procedure||Health A-Z||<p>Children's veins may become damaged by frequent, painful needle insertions. A PICC may be the best way for some children to receive medicines and IV fluids or to have blood samples taken. Learn about this procedure and how to care for the PICC.</p>||<h2>What is a PICC?</h2><p>A peripherally inserted central catheter (PICC) is a special intravenous (IV) line. A PICC is a long, soft, thin, flexible tube that is inserted into a vein in the arm and guided through the veins until it is positioned in a large vein just above the heart. For babies, a PICC might be put into a vein in the leg instead.</p>
<figure class="asset-c-80"><span class="asset-image-title">PICC</span><img src="https://assets.aboutkidshealth.ca/akhassets/PICC_Line_MED_ILL_EN.jpg" alt="A catheter inserted into the vein of a child’s arm with a clamp and access cap on the outside" /><figcaption class="asset-image-caption">A peripherally inserted central catheter (PICC line) is used for patients who need long-term frequent IV therapy. It is inserted into a vein in the arm and ends in a large vein above the heart.</figcaption></figure>||<h2>Why is a PICC inserted?</h2><p>A PICC is used in some children who need IV therapy for a long period of time. IV therapy can include IV medications, nutrition and fluids. Having a PICC inserted makes it easier and more comfortable for your child to receive these IV therapies. If your child has a PICC inserted to receive IV therapies then it can also be used to take blood samples and to provide total parental nutrition (TPN).</p><h2>How is a PICC inserted?</h2><p>A PICC is inserted using image guidance by an interventional radiologist. A needle is inserted into a vein in the arm with the assistance of <a href="/Article?contentid=1290&language=English">ultrasound</a> and a special X-ray called fluoroscopy. Using fluoroscopy, the PICC is guided into the vein until the tip is positioned in the large vein just above the heart. This placement allows for better mixing of medicines and IV fluids.</p> PICC lines are usually inserted in the right arm but can be put into any limb. A chest X-ray may be taken after the procedure to make sure the PICC is in the correct position.
<p></p>||<h2>Key points</h2><ul><li>A PICC is a long, soft, thin, flexible tube that is inserted into a vein in the arm and guided to the large vein just above the heart. For babies, a PICC might be inserted into a vein in the leg.</li><li>A PICC may be the best way for some children to receive IV medications, nutrition and fluids.</li><li>A PICC can stay in for weeks or months.<br></li></ul>||<h2>How long can the PICC stay in?</h2><p>A PICC can stay in for weeks or months, as long as it remains problem-free and working well.</p><h2>Removing the PICC</h2><p>Once your child's health-care team is confident that the PICC is no longer needed, they will make arrangements for the PICC to be removed. This procedure is simple and takes about five to 10 minutes. Sometimes, a cream will be used to numb the skin around the PICC, or a local anaesthetic will be injected into the skin before the PICC is removed. Depending on the type of PICC your child has, or how long it has been in, there is sometimes no need to use any local anaesthetic. Your child will not need any type of sedation.</p>||<h2>On the day of the PICC insertion</h2><h3>Your child will have medicine for pain<br></h3><p>It is important that your child is as comfortable as possible for the procedure. Depending on your child’s age and medical condition, they might be awake during the procedure, slightly sedated (relaxed) or receive general anaesthesia.</p><p>Many children only receive a <a href="/Article?contentid=3001&language=English">local anaesthetic</a> when the PICC is inserted. Local anaesthetic is medication that numbs the area of the arm where the PICC will be inserted. This medication is usually given by a needle into the skin. Once the medication has had time to work, your child should not feel any pain.</p><p>Sometimes, children are given <a href="/Article?contentid=1260&language=English">sedation</a> or a <a href="/Article?contentid=1261&language=English">general anaesthetic</a>.</p><ul><li>If your child receives sedation, they may fall asleep or be sleepy during the procedure. Often, your child will not remember everything that happened during the procedure. Your child will be given a local anaesthetic as well.</li><li>If your child receives general anesthetic, they will not hear or feel anything during the procedure.</li></ul><p>During the procedure, you will be asked to wait in the waiting area.</p>||<h2>After the PICC insertion</h2><p>Once the PICC is inserted, the doctor, nurse or technologist will come and speak with you about the details of the procedure.</p><p>The PICC can be used right away for your child’s medication or fluids. Your child should not feel any pain when the PICC is being used.</p>||<h2>Preparing for a PICC insertion</h2><p>If your child is already in the hospital, you will meet a nurse from the Vascular Access Service who will explain the procedure and answer your questions. If your child is an outpatient, the health-care team looking after your child will explain the procedure to you.</p><p>If your child requires a general anaesthetic for the PICC insertion, you will meet the anaesthetist before the procedure. This is the doctor who will give your child the medicine to sleep during the procedure.</p><h3>Giving consent before the procedure</h3><p>Before the procedure, a member of the interventional radiology team will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks and will help you weigh the benefits against them. It is important that you understand all of these potential risks and benefits of the PICC insertion and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.</p><h3>How to prepare your child for the procedure</h3><p>Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to them to make them feel comfortable during the procedure.</p><p>Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.</p><h3>Food, drink, and medicines before the procedure</h3><ul><li>Your child’s stomach must be empty prior and during sedation or anaesthetic.</li><li>If your child has special needs during fasting, talk to your doctor to make a plan.</li><li>Your child can take their regular morning medicine with a sip of water two hours before the procedure.<br></li><ul></ul></ul><p>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a>, or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. Do not give these to your child before the procedure unless they have been cleared first by your child’s doctor and the interventional radiologist.</p>||<h2>Risks of a PICC insertion for your child</h2><p>A PICC insertion is usually considered a low-risk procedure. The risks of the procedure will vary depending on your child’s condition, age and health.</p><p>The risks of any central catheter insertion, including a PICC, can include:</p><ul><li>failure to find an open vein that will accept the PICC </li><li>bleeding or bruising </li><li>pain or discomfort</li><li>infection</li><li>clotting</li><li>air in the lungs or veins </li><li>irregular heart rhythm </li><li>breakage of the catheter</li><li>movement of the catheter</li><li>X-ray exposure</li><li>vein perforation</li><li>nerve or artery damage</li></ul>||<h2>At SickKids</h2><p>At SickKids, the interventional radiologists work in the <a href="http://www.sickkids.ca/IGT/index.html">Department of Diagnostic Imaging – Division of Image Guided Therapy (IGT)</a>. You can call and speak to the Vascular Access Service resource nurse at (416) 813-6986 during working hours, or leave a message with the Vascular Access Team. If you have concerns and it is after working hours, please call The Hospital for Sick Children switchboard at 416-813-7500 and ask them to page your child’s doctor on call, or go to the nearest Emergency Department.</p><p>For more information on fasting, see “<a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html">Eating and drinking before surgery</a>.”</p><p>For more information on preparing your child for their procedure, see “<a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html">Coming for surgery</a>.”</p>||https://assets.aboutkidshealth.ca/akhassets/PICC_Line_MED_ILL_EN.jpg||Peripherally inserted central catheter (PICC) insertion using image guidance||False|