PICC Lines: What They Are and How to Care for Them at Home

PICC line stands for “peripherally inserted central venous catheter” and it is an intravenous port inserted between the elbow and the shoulder. PICC lines are used for a variety of reasons, but in my case since my chemo concoction was a vesicant, I was required to get a PICC line installed to protect my arm and veins.

PICC lines require daily maintenance at home, weekly maintenance with your doctor or nurse, and you really have to adjust everything you do around them to ensure they are in perfect working order. But, if you are having chemotherapy, they are a cinch during treatment – you don’t have to worry about the nurses trying to find a vein every single time, and they make your lab work a breeze.

Installing PICC Lines

Installation for a PICC line isn’t fun, but it isn’t the end of the world either. At most, you will feel a heck of a lot pressure on your arm for the next 24 hours after it is in, but that feeling goes away. It started out with a specially trained medical professional (I had the best nurse doing mine) identifying the major veins in my left arm via an ultrasound. Once she set her sights on a vein she liked, she made my arm sterile, put a tourniquet on, and then numbed the area of insertion. This needle was actually the worst part of the procedure.

My nurse then threaded the tube from the insertion point all the way to the main vein leading to my heart via the ultrasound. An x-ray was done afterward to ensure it was placed correctly. I think the pressure that I felt in my arm for the next several hours was due to the tourniquet that was in place during the PICC line installation. The PICC line itself gave me no pain or feeling at all.

Care for PICC Lines

PICC lines are pretty easy to care for, really, you just need to be careful around it. You will probably come home with a clear dressing on it, like I did, that held down everything nicely. I had a mesh sleeve around it to keep it from flopping around. You will need to avoid heavy lifting on that arm, no swimming or baths, and it needs to be kept dry at all times.

Every week the dressing needs to be changed. The nurses who do this are typically highly skilled. Once the old dressing is removed, the entire area is cleaned with a cleaning solution (chlorhexidine, iodine, etc.). I was at first given chlorhexidine to clean my arm but it irritated my skin so they switched to the messy brown iodine. After it is all cleaned and the area of insertion is tended to, a clean clear dressing is placed over it, keeping the end free and clear. The injection cap is typically changed at this time, too.

Daily flushings with saline are necessary. I was given sterile plastic syringes that screwed in the end of the PICC lines to flush it. This kept the lines clear to prevent blood clots since I had chemo every other week. Oddly, at every flush, I could ghost taste the flavor of the saline. Crazy stuff. The chemo never had a taste but with each flushing, I had the odd alcohol flavor come into my mouth.

Tips for Showering

The dressing must not get wet under any circumstances. So, baths are obviously out. And unless you shower with one arm in / one arm out of the shower, you need to find a way to keep it dry. Ok, what I’m about to tell you worked wonders for me. I purchased Glad Press’n Seal plastic wrap and wrapped this around my arm. I actually used this same stuff years ago to lay on the dining room table when my kids were doing anything messy that needed a quick clean up (painting with brushes or fingers, gluing stuff on their own, etc.); I just placed this sticky side down when they worked, and then easily removed the mess when they were finished.

This plastic wrap has a slightly tacky side that gently adheres to whatever it touches. My PICC line had a dressing covering that needed to be kept dry at all times, so whenever I showered I took enough from the roll to wrap around my arm twice and pressed to stick. In the 4 1/2 months I had the PICC line in, my line didn’t get wet in the shower once with this method.

Things to Call Your Doctor For When You Have a PICC Line

The risks are low with a PICC line, and as long as it is kept clean and dry and you are careful around it, you shouldn’t have to worry about your PICC line. Having said that, call your doctor if you have major pain in your arm, have a fever, there is bleeding at the insertion point, or if the area is warm or red or there is swelling in the arm or hand of the PICC line. These are all highly indicative of an infection.

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