PICC or Midline Insertion Patient Education

Pre-Insertion Patient Information

What is a PICC or a Midline Catheter?

A Peripherally Inserted Central Catheter (PICC) is a type of Intravenous (IV) line that is placed in a larger vein and is used for treatments that may be hard on smaller veins, such as a course of chemotherapy, and for long-term treatments that may take many weeks or even months. The PICC is a long, thin, flexible tube (catheter) that is inserted through a vein in the arm. Using ultrasound imaging for guidance, the tip of the catheter is moved to a large, central vein in the body called the superior vena cava (SVC) just outside the heart.

A Midline Catheter is a peripheral IV catheter that is longer than a typical IV. It is placed using sterile technique using ultrasound imaging for guidance. It can be used for short term treatments up to 28 days.

What conditions should I make sure my doctor is aware of?

Before your exam, you should notify the doctor or nurse of:

  • Any drug/food allergies
  • Any blood thinning medications (anticoagulants) that you are taking
  • Any medical conditions you have
  • Any restricted limbs

What are the risks?

Generally, this is a safe procedure. However, as with any procedure, complications can occur. Possible complications include:

  • This may happen at the insertion site or internally.
  • This may occur at the insertion site or in the blood.
  • PICC malposition. This is movement or poor placement of the PICC.
  • Inflammation of the vein (phlebitis).
  • Nerve injury or irritation.
  • Clot formation at the tip of the PICC.

Other risks include:

  • Blood clot in the lung (pulmonary embolus).
  • Injury or collapse of the lung (pneumothorax).
  • Injury to the large blood vessels or the heart.

About the Procedure

The day of the procedure:

  • Make sure you shower and wash both arms with soap and water.
  • Please arrive and register at admissions in the lobby of the hospital at your scheduled time.
  • You will be escorted to the room where your line will be inserted.
  • The nurse will review your medical history and medications.
  • If you are having a PICC inserted, the nurse will obtain your consent. No consent is needed for a midline catheter insertion. The nurse will explain the procedure including possible complications and side effects. They will also answer any questions you may have.

During the procedure:

  • The nurse will find a vein into which the PICC or midline will be inserted. This will be done using ultrasound guidance.
  • You will be given a medicine to numb the area (local anesthetic).
  • A tourniquet will be placed on your arm to control blood flow to the area.
  • Drapes will be placed over your body where the PICC or midline will be inserted.
  • A small needle will be put into your vein, and then a small guidewire will placed.
  • The catheter will be advanced over the guidewire and moved into place. The guidewire will then be removed.
  • The catheter will be flushed, and blood will be drawn back to make sure the catheter is in the vein.
  • Proper positioning of the catheter tip will be confirmed for a PICC placement. An X-ray may be taken.
  • The PICC will be secured to your skin using a device that sticks to your skin.
  • A type of germ-free bandage (sterile dressing), such as an airtight (occlusive) sterile dressing, will be placed over the PICC insertion site.

After the procedure:

  • You will be told how to care for your PICC or midline catheter.
  • You will be escorted back to the main area of the hospital.

Contact Information

Please contact your ordering provider with questions or concerns.

In case of emergency including:

  • Severe biopsy site redness, swelling, bleeding
  • Shortness of breath
  • Chest pain

 Report to the nearest Emergency Room or call 911

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