Your child may feel a slight pin prick when the IV line needle is inserted and the local anesthetic is injected. Your child may not remain awake, depending on how deeply your child is sedated.Ī tourniquet (a band tied tightly around the arm) may be used to help enlarge the vein and make it easier to place the PICC line. If the procedure is done with sedation, the IV sedative will make your child feel relaxed, sleepy and comfortable for the procedure. What will my child experience during the procedure?ĭevices to monitor your child's heart rate and blood pressure may be attached to their body. If image guidance was not used during placement of the PICC, an x-ray may be taken to ensure the catheter is correctly positioned. A special bandage is placed on the insertion site to keep the line secure. The guide wire is removed and the catheter is tested. The catheter is advanced over the wire until the tip of the catheter is in an appropriate position. Next, a thin guide wire is inserted through the needle and moved through the vein using x-ray ( fluoroscopy) or ultrasound guidance. A small needle will be inserted into the site using ultrasound as a guide. The doctor or nurse will numb the area on the arm with a local anesthetic. The skin at the PICC insertion site is cleaned and covered with a sterile surgical drape. Tell the doctor or nurse in advance if your child has a strong preference for where the catheter is placed. The doctor or nurse will use ultrasound to identify the best vein to use for the procedure, usually a vein within the arm. An IV line will be inserted into a vein in the hand or arm if IV sedation is needed. Straps and bolsters may be placed to help your child remain still. Your child will be placed face up on the table. Procedure length varies, although it usually takes about an hour to complete. PICC line placement can be performed on an outpatient or inpatient basis. PICC lines are occasionally placed in an operating room, or at the bedside without image guidance. PICC lines are most often placed by a specially trained healthcare professional, such as an interventional radiologist, in an interventional radiology suite. Other equipment that may be used include devices to monitor your child's heart rate and blood pressure. PICC lines may have as many as three openings and may be used for injection of medicine or contrast material. A PICC line that does not extend as far as the superior vena cava is called a midline catheter. Fluoroscopy allows the doctor or nurse to watch the wire and catheter on a live display so they can safely advance the catheter into position.Ī PICC line is a thin plastic or silicone tube ( catheter) long enough to extend from a patient's arm vein to the largest vein near the heart (the superior vena cava). This helps improve the likelihood of a successful PICC line placement and to minimize the risk of complications, such as bleeding.įluoroscopy, which converts x-rays into video images on a screen, is used to watch and guide the procedure. Ultrasound is helpful because it provides the doctor or nurse with real-time guidance finding a vein. Ultrasound gel is used to improve the quality of the image. It is used to look for veins that may be larger and deeper than veins that can be seen or felt on the skin surface. Ultrasound is used to assess and identify a vein for catheter placement. A video display screen and a transducer that is used to scan the body also are included. Ultrasound scanners consist of a console containing a computer and electronics. In this procedure, ultrasound and x-ray equipment, a needle, a guide wire and a PICC line are used. Jewelry, removable dental appliances, eye glasses and metal objects might interfere with the x-ray images. Your child will wear a gown during the procedure. You may be told to withhold food or drink several hours before the procedure if anesthesia or sedation is to be used. These will include any changes to their regular medication schedule. You will receive specific instructions on how to help your child prepare. Do not stop your child's medication until you have been given the doctor's approval. Your child's doctor may advise you to withhold aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners a few days before the procedure. List any allergies, especially to local anesthetic, general anesthesia or to contrast materials containing iodine. You should report all medications that your child is taking, including herbal supplements. Your child's blood may be tested before PICC line placement to check if certain blood levels are safe for the procedure.
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