Pediatric Peripherally Inserted Central Catheter (PICC) Line

First an interventional radiologist at Children's National Hospital will perform an ultrasound of the extremity chosen for the PICC to identify the vein to be accessed. Then the doctor will insert a needle into the vein followed by a guide wire that will be imaged under X-rays and used to make measurements, which will allow the catheter to be cut to the desired length. Once cut to length, the catheter will be advanced to the level of entry into the right heart. A typical PICC placement takes approximately 30-60 minutes.

Newborns and young infants can be swaddled during the procedure and distracted with oral sucrose. Young children are usually given intravenous (IV) sedation or general anesthesia so that they are not awake and do not move during the procedure. Older children who can follow commands can be given local numbing medication only and can watch a movie or listen to music during the procedure for distraction.

For children that are awake, a small pinprick will be felt when we inject the local numbing medication. After the procedure your child may feel discomfort or tenderness around the catheter insertion site for a few days. Over-the-counter pain medications should help relieve this discomfort.

PICC placement is considered a low-risk procedure. However, potential complications include:

• Bleeding
• Infection
• Formation of a blood clot in the vein (thrombosis)
• Abnormal heart rhythm
• Injury of adjacent structures (such as other arteries, veins or nerves)

Your child may shower or bathe, but the PICC may not be submerged underwater and the dressing must remain dry at all times to prevent infection. A water-resistant covering can be placed over the PICC to keep it dry. If you have questions about how to make this, please ask an Interventional Radiology team member.

If properly cared for, a PICC line can stay in for weeks to months. PICC lines require daily flushing and weekly dressing changes. Your medical team will help arrange for this care at home.

Your child will be able to resume most activities, including day care or school. Your child should be discouraged from activities, such as football and rough playing, which may result in a pull to the PICC line and can lead to damage or loss of the catheter. If you have questions about which activities are okay, please ask your provider.