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PICC Use and
Care for the Home Patient
Chemotherapy for cancer
treatment is increasingly delivered intravenously by
boluses or by continuous infusion in both outpatient
and home settings. PICCs, accordingly, are becoming
the first choice route to deliver long-term chemotherapy,
hematology products or total parenteral nutrition (TPN)
in cancer patients. PICCs are also used extensively
in non-cancer patients who require long-term antibiotics
necessary for treatment of such conditions as lyme disease,
osteomyelitis, or cellulitis. They can be inserted safely
by specially trained nurses, managed easily at home
and are associated with very low risks and serious complications
compared to other central catheters.
A PICC line is essentially
a narrow flexible catheter inserted through a vein of
the upper arm above the elbow until its tip reaches
a very large heart called the superior vena cava (SVC).
Its placement simply consists of one cannulation, which
can be carried out in the home at times if necessary.
Significant risks of the procedure are minimal. After
insertion, the line can remain in place for a few weeks
up to a year, depending on many factors, including purpose
of use as well as care and maintenance.
PICC lines are quite
easily maintained, with dressing changes normally required
weekly and flushing lines with one or two solutions
at recommended intervals depending on its use and catheter
design. Many patients are taught self-care making them
less dependent on PICC nursing teams, specialist vascular
nurse or home health care providers.
Infection is a constant
risk with all intravenous devices. However, the reported
rates of infection from PICC lines are relatively low.
The risk of thrombosis of arm veins is also quite small,
although some hospitals prescribe the anti-clotting
agents like warfarin as a precautionary measure.
For minimizing problems
associated with PICC lines, guidelines include:
- Always wash hands
before touching the PICC line.
- Do not allow any
sharp objects near the line.
- Do not clean the
skin near the line with any acetone containing cleanser.
- Keep the insertion
site and dressing dry.
- Do not go swimming
as swimming pools not only harbor bacteria but a wet
dressing is an ideal medium for bacterial growth.
- Do not allow pets
or young children to play with the PICC line.
- Change dressings
only after proper training and completely aseptically
and applies to any family members or other caregivers.
- Seek professional
help immediately if any discharge, redness, swelling
or pain around the catheter insertion site is noticed.
Knowledge of maintenance
and care of PICC lines insures long term use. Problems,
detected early, greatly decrease any complications that
might be associated with this line. It is important
to address any concerns with individuals trained in
PICC line care.
The consumer health information
on this Website is for informational and educational
purposes only and is not a substitute for medical advice
or treatment for any medical conditions.
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