Picc (Peripherally Inserted Central Catheter) in Children
Medically reviewed by Drugs.com. Last updated on Apr 2, 2024.
AMBULATORY CARE:
What you need to know about a peripherally inserted central catheter (PICC):
A PICC is a catheter (small tube) used to give treatments and to take blood. The catheter is usually inserted into an arm vein. In infants, a leg vein may be used. These arm and leg veins are called peripheral veins. The catheter is guided through the peripheral vein into a central vein near your child's heart.
Why your child may need a PICC:
- Your child needs to have blood drawn often.
- Your child will be given medicines often, or he or she needs medicines that must work quickly.
- Your child's central venous pressure needs to be monitored.
- Your child needs IV medicines after he or she leaves the hospital. The PICC allows your child to get his or her medicines at home.
- Your child cannot eat or drink anything by mouth.
What you need to know about how a PICC is placed:
- Your child will get local anesthesia to numb the area. The catheter will be put into a vein. It will be guided up until the tip is in the vena cava. This is an area close to your child's heart. Ultrasound or x-ray pictures will be used to make sure the catheter is in the correct position. The other end of the catheter will stay outside your child's body.
- The catheter will be flushed with liquid. Heparin may be used to flush the line to prevent blood clots. Medicine will be placed at the insertion site (the place where it goes into your child's skin). The medicine helps prevent an infection at the site.
- The catheter will be secured to your child's skin with a dressing. The dressing holds it in place, keeps it clean, and helps prevent infection. The dressing will be clear so you can check the insertion site for signs of infection. Another x-ray helps make sure the catheter is in the right place and is ready for your child to use.
- Healthcare providers will watch your child for problems during the PICC placement. He or she could have bleeding when the PICC is inserted. An infection could develop at the insertion site. An infection that enters your child's bloodstream can cause serious illness. Rarely, your child's lung could get pierced when the PICC is inserted. This can cause a collapsed lung.
What healthcare providers will teach you about the PICC:
Depending on your child's age, he or she may also be taught the following:
- Supplies you need to keep on hand to use, care for, and flush the PICC
- How to use the PICC, and when to keep it clamped
- How and when to flush and care for the PICC
- Problems that may develop, such as a hole in the catheter, and what to do to fix the problems
- How to bathe and do daily activities with a PICC in place
- How to prevent infections
- Signs and symptoms of an infection to watch for and what to do if an infection develops
Call your local emergency number (911 in the US) for any of the following:
- Your child feels pain in his or her arm, neck, shoulder, or chest.
- Your child coughs up blood.
Seek care immediately if:
- The catheter site turns cold, changes color, or your child cannot feel it.
- You see blood on your child's dressing and the amount is increasing.
- The veins in your child's neck or chest bulge.
Call your child's doctor if:
- You see signs of infection, such as redness, swelling, or pus, or your child has a fever.
- The catheter site is red, warm, painful, or oozing fluid.
- You see blisters on the skin near the catheter site.
- You cannot flush the catheter, or your child feels pain when the catheter is flushed.
- You see that the catheter is getting shorter, or it falls out. Put pressure on the site with a clean towel before you call your child's doctor.
- You see a hole or a crack in your child's catheter. Clamp the catheter above the damage before you call your child's doctor.
- You have questions or concerns about your child's catheter.
Medicines:
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children younger than 6 months without direction from a healthcare provider.
- Do not give aspirin to children younger than 18 years. Your child could develop Reye syndrome if he or she has the flu or a fever and takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin or salicylates.
- Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell the provider if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.
Care for your child:
- Help your child rest when he or she gets home. Your child should be able to go back to his or her normal activities the next day. Your child's healthcare provider will tell you which activities are okay for him or her. Do not let your child play sports until his or her healthcare provider says it is okay.
- Apply a warm compress as directed. The area where the catheter was inserted may feel sore. A warm compress can help to decrease pain and swelling in your child's arm. Wet a small towel with warm water. Wring out the extra water. Wrap the cloth in plastic, and put it on the area. Use the compress 4 times a day, for 10 minutes each time. Prop your child's arm up on pillows when he or she is sitting or lying down. This will decrease swelling.
- Follow instructions on how to care for the insertion site. Your child's provider will tell you when it is okay for him or her to shower or bathe. This is usually after about 1 week. Your child will need to keep the area covered so it stays dry when he or she bathes.
Prevent an infection:
The area around your child's catheter may get infected, or he or she may get an infection in his or her bloodstream. A bloodstream infection is called a central line-associated bloodstream infection (CLABSI). A CLABSI is caused by bacteria getting into your child's bloodstream through the catheter. This can lead to severe illness. The following are ways you can help prevent an infection:
- Wash your hands and your child's hands often. Use soap or an alcohol-based hand rub. Clean your hands before and after you touch the catheter or the catheter site. Remind anyone who cares for your child's catheter to wash his or her hands. Teach your child not to handle or play with the PICC.
- Limit contact with the catheter. Do not touch or handle your child's catheter unless you need to care for it. Do not pull, push on, or move the catheter when you clean his or her skin or change the dressing. Wear clean medical gloves when you touch the catheter or change dressings.
- Keep the area covered and dry. Keep a sterile dressing over the catheter site. Wrap the insertion site with plastic and seal it with medical tape before your child bathes. Have your child take showers instead of baths. Do not let your child swim or soak in a hot tub.
Follow up with your child's doctor as directed:
Write down your questions so you remember to ask them during your visits.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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