University Health Care Infusion Services

Vascular Access Services

Peripherally Inserted
Central Catheter (PICC)
Midlines

PICC lineA PICC is a type of central catheter that is inserted in the upper arm and terminates in the superior vena cava, where there is nearly 2 liters of blood flow per minute in adults.  The large amount of blood flow dilutes vessicants and eliminates chemical phlebitis.

PICCs 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.

midlinesMidlines are a type of peripheral IV that are inserted 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 hours.  A midline 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 IVs with a pH greater than 5 or less than 9. Continuous vesicants or irritants like chemotherapy, dopamine, and TPN that contain more than 10% dextrose, and medications with extremely high or low pH should not be infused through a midline. 

Difficult peripheral IV starts Difficult blood draws
Difficult IV startsThe PICC Team can be paged for requests to start difficult peripheral IVs using the ultrasound. 

 

Difficult blood drawThe PICC Team can also be paged for difficult lab draws where an ultrasound is necessary to assist in gaining access to vessel.