PICC Line, Peripherally Inserted Central Catheter

  • Indications
  1. Outpatient intravenous management
  • Complications
  1. Minor complications
    1. Entry site infection
    2. Phlebitis
    3. PICC Line port Occlusion (e.g. one port on a triple lumen catheter)
      1. TPA 2 mg reconstituted in 2.2 ml sterile water injected into occluded port
        1. Attempt aspiration and repeat attempt aspiration every 30 minutes for 2 hours
        2. If aspiration is successful, withdraw 4-5 cc blood, and then flush catheter
      2. If unsuccesful, may repeat the TPA injection protocol once as above
  2. Major complications
    1. Pulmonary Embolism (0.1% risk)
    2. Venous Thrombosis (2.5% risk)
      1. See PICC Line Thrombosis
      2. Higher risk with Amphotericin B (10x risk)
      3. May present as serous drainage from the PICC insertion site
      4. Ultrasound with high frequency linear probe starting at insertion site and scan up extremity
        1. Observe for clot and compressibility
        2. Any concerns should prompt formal Ultrasound