Peripherally Inserted Central Catheter (PICC)

  • Reference Number: HEY-392/2016
  • Departments: Oncology (Cancer Services)

Introduction

This leaflet has been produced to give you general information about your procedure in order to prepare you before your next appointment. Most of your questions should have already been answered and you will have been provided with an additional Macmillan PICC fact sheet.   If after reading the information you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you or contact the Macmillan Chemotherapy Clinical Nurse Specialist (CNS) Team on the number provided at the end of this leaflet.

What is a PICC?

PICC stands for Peripherally Inserted Central Catheter. It is a long, thin, flexible tube (a catheter) that is inserted into a large vein in your upper arm, guided by ultrasound, until the tip of the line ends in a large vein adjacent to your heart; the other end remains outside the body with a safety cap to secure the end. It is one of three central venous access devices (CVAD) that are available.  These include a skin tunnel catheter (STC) and PORT-A-CATH.

It will have been discussed with you that a PICC is required in order to gain access to your venous (blood) system and to allow treatment to be administered safely. They will have also considered other CVAD options if appropriate and discussed the suitability with you before referring you for a PICC line.

The procedure will be carried out by a Macmillan Chemotherapy Clinical Nurse Specialist (CNS) in the Queen’s Centre for Oncology and Haematology at Castle Hill Hospital. The CNS has specific knowledge and skills in ultrasound and associated specialist equipment used in PICC placement.  If you have not already received a date to attend the PICC clinic in the Outpatient Department the CNS team will ring you to arrange a suitable appointment.  If you are an inpatient at the Queen’s Centre, the CNS team will arrange an appropriate time and can carry out the procedure on the ward if necessary.

Can there be any complications or risks?

The Macmillan fact sheet provides information on the management and potential problems of a PICC. This will be explained in more detail by a CNS at your appointment for the procedure and they will provide reassurance about how you and your line will be cared for. You will be asked to sign a consent form prior to the procedure.

How do I prepare for a PICC placement?

On the day of the procedure, you can eat and drink and take any medication as normal. Please bring any additional medication with you that you may require during the appointment time.  You may bring someone with you and we advise that someone drives you home on this occasion.  The entire appointment will last at least two hours, although the procedure itself is approximately 30 minutes.

Please wear a short sleeved garment to allow access to your upper arm.

What will happen?

On your arrival to The Queen’s Centre please book in at reception desk. You will be informed if you require a blood test prior to the procedure.  A CNS will call you to a clinical room to discuss the procedure in more detail; assess your needs and answer any questions you may have.  The CNS will assess the veins in your upper arms using an ultrasound machine and apply anaesthetic ointment to the chosen site for your comfort. You will have time to visit the toilet or have a drink whilst the ointment works and the CNS sets up for the procedure. You will be then be called back into the clinical room at an agreed time to carry out the procedure as discussed and you will be asked to lie on a bed for the duration of the PICC placement.

What happens afterwards?

On completion of the PICC placement procedure, a dressing will be applied to the PICC area and you will be sent to the X-ray Department to confirm the tip position. The CNS can then confirm that the position is correct and any adjustments can be made for safety and comfort on your return from X-ray.

You will be provided with a PICC card that has all necessary information including 24 hour contact numbers. Arrangements will be made for you to have a post PICC insertion check and dressing change. Your next appointment or treatment dates will be confirmed to allow any further management plans.  You will then be able to leave the department.

Should you require further advice or reassurance on the issues contained in this leaflet, please do not hesitate to contact the Macmillan Chemotherapy CNS team directly on: Telephone number: (01482) 461082

Useful websites:

www.macmillan.org.uk

www.hey.uk/queens

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.