Peripherally inserted central catheter for long-term IV access.
Indications
- • Prolonged IV antibiotics
- • Chemotherapy
- • TPN
Contraindications
- ⚠ Local skin infection
- ⚠ Bilateral mastectomy/lymphedema
- ⚠ AV fistula arm
Equipment
- • USG
- • PICC kit (single/double lumen)
- • Sterile drape
- • ECG guidance system
Positioning
- • As appropriate for the procedure and patient comfort.
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/6)
Tap to complete
Non-dominant arm above elbow.
2. Measure length
3. Sterile prep + max barrier
4. Insert via micropuncture
5. Advance to SVC/right atrium junction
6. Secure & dressing
Immediate complications
- ⚠ Arrhythmia
- ⚠ Malposition
Delayed complications
- • Thrombosis
- • CRBSI
- • Occlusion
Recognition
- • Arm swelling
- • Redness
Initial management
- • Anticoagulation for DVT
- • Remove if infected
Prevention
- • Aseptic technique
- • Correct tip position
Post-procedure observation
- • Vitals q15min × 1h then hourly
Monitoring
- • Site inspection
- • Symptom review
Documentation
- • Procedure note
- • Consent
- • Findings
Patient instructions
- • Report pain, bleeding, fever, worsening symptoms
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
