Carolina Vascular Wellness - Clinical Education

Frequently Asked Questions

What is a PICC line?

A peripherally inserted central catheter (PICC) is a thin flexible catheter, ideally inserted into the large veins of the upper arm and extending to the lower third of the body’s large central vein, the Superior Vena Cava (SVC). PICC lines are typically used because certain medications have the potential to severely damage tissue and smaller blood vessels if they are not quickly diluted. The turbulent flow characteristics of the lower third of the SVC provide areas of optimal drug dilution, allowing safe, rapid transport to the rest of the body.

What about the risks and potential complications?

The risk of infection is very low with proper hand hygiene and line management. However, it is possible to develop infections that require removal of your catheter. It is also unlikely but possible that the catheter tip may move out of position with excessive coughing, vigorous movement, or severe vomiting. Techniques can be used to return the PICC to the correct position.
As with any intravenous procedure, phlebitis (venous inflammation) or thromboses (clot formation) are risks. At Carolina Vascular Wellness, risks like these are minimized through ultrasound measurement of the vein prior to insertion, and accurate placement of the catheter tip.

When is a PICC line the right choice?

PICCs are the vascular access option of choice for patients with a history of multiple IV attempts, patients expecting hospital stays of more than a week, and for patients receiving infusions of medications that cause pain and damage to the small veins and surrounding tissue of the arms and hands. With a PICC line, virtually all intravenous medication, lab work, blood transfusions and radiological exams can be done after one relatively painless stick for the PICC insertion, thus eliminating the associated bruising and tissue damage of prolonged IV attempts.

What about long-term needs like chemotherapy?

For chemotherapy and other extended treatments, small, low-profile peripheral ports are safely placed in our outpatient clinics. These well-tolerated ports are cosmetically advantageous to ports placed in the chest, require minimal maintenance and can safely remain in place throughout the entire course of long term therapies. Our active patients and female clients planning reconstructive surgery find low-profile peripheral ports an ideal cosmetic solution to the surgery involved in the placement of traditional chest ports.

How is a PICC line inserted?

Most central lines are inserted into the neck or chest wall. Adult PICC lines, however, are inserted into the upper arms, ideally under ultrasound, above the bend of the elbow. A PICC must always be inserted as a sterile procedure, and state-of-the-art insertion techniques include local anesthetic, tip location and maximum sterile barriers.

Why is tip location important?

An accurately placed PICC line reduces clot formation and other post-insertion complications. Tip location was developed specifically to reduce the complications inherent in malpositioned catheters. By using new, state-of-the-art tip location devices, our nurses and physicians can visualize catheter placement in real time without the risk of fluoroscopy or additional X-rays. At Carolina Vascular Wellness we emphasize this patient-centered technology to improve insertion results and reduce patient exposure to radiation.

How does tip location differentiate Carolina Vascular Wellness?

Our mission to change healthcare requires uncompromising standards of patient-centered care, and must ultimately improve the experience of every patient we see. While slightly more expensive, next-generation tip location provides a level of patient care and attention to detail that defines Carolina Vascular Wellness. Tip location techniques allow us to accurately place our PICC lines without the need for interventional radiology.

What is the biggest benefit of using Carolina Vascular Wellness?

Our patients are our first priority. We work diligently with hospitals, facilities and physicians to transition patients from diagnosis, through treatment and into recovery. Within the hospital, our teams attend to patients quickly and safely, ultimately improving treatment times and reducing days of uncompensated care while waiting for vascular access. Our outpatient facilities reduce hospital overcrowding and provide an alternative to unnecessary admissions.  Specialized care facilities benefit from same day, hospital equivalent PICC insertion within the facility, allowing care to continue without disruption and eliminating the unnecessary costs and risks of transportation to the hospital.
For patients outside the hospital setting, our services begin on the day ordered, including PICC or port insertion, education and first infusion in one of our comfortable clinics.

Where are CVW vascular access services available?

CVW can place PICC lines and peripheral ports in a variety of settings, including hospitals, specialty care facilities, surgical centers, physician offices, or at one of our outpatient clinics. For outpatient clients, PICC and peripheral port insertions performed in our Cary, Durham and Oxford clinics permit prompt, safe and reliable vascular access. Our goal is to provide our patients with services which allow them to remain in the environment optimal for a normal, healthy lifestyle throughout their intravenous therapy.

What is the insertion process like?

Following an ultrasound examination of the arms, a local anesthetic will be administered and the PICC, port or midline procedure will begin using ultrasound guidance. Once the selected vein has been accessed, the PICC will be inserted into proper position using next-generation tip location techniques. Most patients feel little or no discomfort. A chest X-ray will be taken for final tip verification of the PICC line. Once the placement of the tip has been verified, the PICC site will be covered with a sterile dressing and your treatment can begin.

Can I eat and drink before having my PICC inserted?

Yes, we prefer you eat and drink normally prior to having your PICC, midline or peripheral port procedure.

What should I expect after the PICC line insertion?

After insertion, simple but important care instructions are reviewed with you and your family by a Carolina Vascular Wellness nurse. It is possible to experience some tenderness or bruising of the upper arm at the insertion site after the PICC is placed. This will usually go away within 36 hours. If symptoms worsen or persist, contact us immediately.
Occasionally, a small amount of blood leaking from the PICC insertion site may occur during the first 24 hours following your procedure. This is normal, and typically stops with three to five minutes of very light pressure over the insertion site. Please call our 24-hour hotline with any questions.

How do I take care of my PICC line at home?

If you are a hospital patient, your nurse case manager or discharge planner will make your aftercare arrangements for you. Once you are at home, the nursing staff at a home care agency typically manages PICC maintenance care. As an alternative, PICC and port care can be managed at the Carolina Vascular Wellness clinics. Call Carolina Vascular Wellness or check with your physician for simple but important guidelines and questions regarding care and maintenance of your particular PICC or central line.

Can I bathe, shower or swim?

As a general rule, we encourage patients with a PICC line to shower. Always cover the PICC insertion site with clear, plastic wrap and tape before showering. Swimming is not recommended. If you submerge your PICC under water, you increase the chance of infection. If PICC, midline or peripheral port dressings become wet, loose or damaged, new dressings should be applied as soon as possible.

Can I play sports?

Sports which require vigorous arm movement such as martial arts, tennis, golf or gymnastics exercises are strongly discouraged. If you participate in strenuous activities, your PICC may become dislodged. However, activities such as walking or non-competitive bicycling are typically well tolerated. If you are in doubt, feel free to ask your doctor or one of our trained healthcare professionals.

What’s the first step?

The referral process is simple and easy. Fill in, print and fax the Referral Order Form (PDF) from our Quick Links tab on the home page. Finish the referral with a telephone call to CVW. Same day appointments are available.