Vascular Access Services
Centeral Catheter (PICC)
A PICC is a peripherally inserted central catheter that terminates in the vena cava, where a large amount of blood as well as the turbulence of the blood avoids the problem of chemical phlebitis. Peripheral veins cannot tolerate the constant flow of a very hypertonic solutions.
PICC’s are used for total parenteral nutrition (TPN), antibiotic therapy, medications, chemotherapy, intravenous fluids and blood draws. A PICC catheter is recommended when IV therapy is required for at least 7 days for those patients with poor venous access.
Midlines are placed in the upper arm using the basilic , brachial or cephalic veins with the tip ending below the level of the axillary line measuring between 5 -10 inches (10-20 cm). This device provides an alternative to the short peripheral IV’s that have to be replaced every 72- 96 hrs and can stay in the arm for up to 4 weeks. The only drugs or solutions that can be safely infused through a Midline are the same drugs that are safe for peripheral IV’s with a pH greater than 5 or less than 9. Continuous vesicants or irritants like chemo, dopamine and TPN that contain more thatn 10% dextrose and medications with extremely high or low pH should not be infused through a midline.
|Difficult peripheral IV starts||Difficult blood draws|
|When called, the PICC team comes to place PIV’s in patients using ultra sound to access deeper larger veins on patient’s.||There are patients that phlebotomy had difficulty drawing blood on. They call us and we come with the ultrasound to gain access and get the blood for testing.|