Diff b/w PICC and Central Line

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What is the difference b/w a PICC line and a Central line? I would like this helpful information. Thanks.

Angela

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Specializes in LTC,Hospice/palliative care,acute care.

Alternative names

Peripherally inserted central line long-term intravenous catheter

Definition

a picc line is a long, soft, flexible tube, or catheter, that is inserted through a vein in the arm. The picc catheter is designed to reach one of the larger veins located near the heart. It is longer and thinner than a regular intravenous catheter. A picc line is frequently used in the home setting.

When is a picc line used?

A picc line is used when a person needs intravenous medication, chemotherapy, or fluids for an extended period of time. It is also used when someone requires frequent blood sampling. The most common use for a picc line is for giving antibiotics and chemotherapy through the veins.

How is the picc line placed?

A doctor or specially trained registered nurse will place a picc line in a person's arm. The procedure is done either in a hospital or in an outpatient facility. Using a needle or a guide wire, the provider inserts the picc line into a vein located in the arm. From there it is threaded into a larger vein near the heart. Once the catheter is in the correct position, the needle or guide wire is removed and the catheter is left in place.

The catheter site is covered with a sterile dressing and the tubing is securely taped to the person's skin. Plastic tubing is connected to the end of the catheter. A chest x-ray will be done after the picc line is inserted to check that it is correctly placed.

How long can a picc line stay in place?

The picc catheter can generally remain in place from five days to several months. In some cases, the catheter can remain in place for up to a year.

What type of care does the picc line require?

The dressing is changed once a week by a registered nurse. If the catheter is not being used continuously, the nurse will flush the line with saline solution to prevent it from clogging.

What precautions should be taken after a picc line has been inserted?

The catheter site must be kept dry. The person may bathe or shower as long as the insertion site is protected with a water-resistant covering. The person's blood pressure should not be taken in the arm with the picc line. The picc line site should be checked every day for signs of infection, such as redness, swelling, or pain.

What are the complications associated with a picc line?

A picc line is designed to stay in place for many months. However, the catheter can sometimes cause phlebitis, or vein irritation. If this occurs, a red streak may appear on the arm, and the healthcare provider should be notified. Infection is also possible, but rare. The nurse or doctor should also be notified if the person develops a fever, chills, or a rash.

Central line

Alternative names?

Central venous catheter, cvp line

Definition

A central line is a special intravenous line, called an iv. This type of iv is inserted through the chest and threaded into one of the large veins that lie close to the heart. A central line has multiple ports that can be used to:

  • Draw blood
  • Give fluids
  • Monitor central venous blood pressure

Who is a candidate for the procedure??

A central line is used for:

  • Gaining emergency iv access when the usual iv access into an arm vein is not possible
  • Monitoring central venous pressure during major surgery or after severe blood loss from trauma or illness
  • Giving fluids, blood products, chemotherapy , and other medicines, as well as for hyperalimentation
  • Drawing blood samples
  • Administering long-term iv therapy

How is the procedure performed??

A central line is inserted under sterile conditions. The person is usually placed in the trendelenburg position, which means the head is below the level of the heart. The skin is cleansed, and a local anesthetic is injected to make the area numb. A healthcare professional advances the line until it reaches the large vein of the chest. The catheter is then sutured in place, and a sterile dressing is applied.

What happens right after the procedure??

A chest x-ray will be done right away after a central line is inserted to confirm that it is in the right position. The line should not be used until the x-ray is done. A central line can usually stay in place for up to 4 weeks.

What happens later at home??

If the person is going home with the central line, the family will need to learn how to care for the catheter. A visiting nurse can come to the home to help the family with the care at first. The bandage at the insertion site will need to be changed every 3 days. The insertion site should also be inspected closely for signs of infection. These signs include redness, warmth, drainage, and swelling.

What are the potential complications after the procedure??

While inserting the line, it is possible to puncture the lung. The catheter may irritate the heart and cause irregular heartbeats, called arrhythmias. Other complications may include:

  • Air embolism
  • Bleeding
  • Blood clot in the tubing
  • Infection

Any of these complications may lead to the removal of the central line.

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Wow thanks for your thorough and complete explanation extremely helpful. I am so happy I found this site. I wish I found it sooner.

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One of the complications of Central lines listed above, is the possibility of puncturing the lung upon insertion. Is this not a problem in PICC placement?

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In General Terms, the only difference between a PICC and Central Line is Insertion Site.........Arm versus chest or neck...........The tip of the device resides in the same location..............

The PICC is a long term catheter, up to a year and a central line is a short term catheter.

PICCs are easier and safer to insert.......They have a significantly decreased infection rate, and overall is the better catheter to have in most situations.

By the Way, a PICC line is a central line.......So many people state that a PICC is not a central line....IT IS... The tip is located in a central vein (superior vena cava).

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I do realize that a PICC is a Central Line. However, in research that I have done, I have seen lung puncture listed as a complication when referring to central lines in general, but not PICC specific.

You state that a PICCs are easier and safer to insert. Does that mean that there is not a possibility of puncuturing the lung during insertion? Or if it is a possible complication what is the incidence?

Thanks

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bobnurse said:
In General Terms, the only difference between a PICC and Central Line is Insertion Site.........Arm versus chest or neck...........The tip of the device resides in the same location..............

The PICC is a long term catheter, up to a year and a central line is a short term catheter.

PICCs are easier and safer to insert.......They have a significantly decreased infection rate, and overall is the better catheter to have in most situations.

By the Way, a PICC line is a central line.......So many people state that a PICC is not a central line....IT IS... The tip is located in a central vein (superior vena cava).

Both PICC and Central line are both central venous catheters based on the tip of each catheter resting in the SVC.

The insertion of each catheter differs in that PICC lines can be placed by nurses and are inserted in arm. Length of use can be from couple of weeks to over a year.

Central Venous Catheters are placed by physicians, are inserted in the chest. Depending on the type of CVC determines length of time they are left in place. A triple lumen Subcalavian is a non-tunneled catheter that usually left in place for up to 2 weeks. Tunneled CVC such as Hickman/ Broviac/Groshong are intended for long turn use, sometimes several years if cared for properly

Donna

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jlnoyce said:
I do realize that a PICC is a Central Line. However, in research that I have done, I have seen lung puncture listed as a complication when referring to central lines in general, but not PICC specific.

You state that a PICCs are easier and safer to insert. Does that mean that there is not a possibility of puncuturing the lung during insertion? Or if it is a possible complication what is the incidence?

Thanks

I insert PICC's using the microintroducer technique, which in a sense is no different than starting an IV in the uppper arm.......A 20 gauge angio cath is used to access either the cephalic or basilic vein.........Its more complex than im stating, but really a simple process....

No chance of puncturing a lung, since your sticking the arm, not the chest cavity. The biggest risk with PICC's is infection (but signifantly lower than subclavian or jugular), clots, phlebitis.......There are more, but overall pretty low.....Ive put in over 600 PICC's, and have had very few problems, and those that got infected usually had TPN infusing through them.

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jlnoyce said:
I do realize that a PICC is a Central Line. However, in research that I have done, I have seen lung puncture listed as a complication when referring to central lines in general, but not PICC specific.

You state that a PICCs are easier and safer to insert. Does that mean that there is not a possibility of puncuturing the lung during insertion? Or if it is a possible complication what is the incidence?

Thanks

PICC lines are usually inserted via the right peripheral basilic vein and advanced to the Superior Vena Cava and are characterized as LOW/NO risk of pneumothorax contrasted with sub-clavian central line insertion which carries the higher risk of pneumothorax. Sorry but, off hand, I do not have any statistics. If you need statistical info you could do a google search or email the American Infusion Society.

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What is the difference in dressing changes. I changed a central last week but yesterday when I changed the PICC it had strips. So is that the only diff and what are the strips called and how should they be placed???

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Strips meaning steri-strips to hold it down? some people use them, many dont.

The biggest difference in dressing changes is to ensure that your pulling the opsite towards the insertion site to minimize pulling the catheter out. Otherwise, the dressing change is similar to a subclavian line. We use the stat-loc device to secure our piccs.........

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In relation to taking blood from a picc, what is the degree of hemolysis that occurs? Consider the soft nature of the picc means it will collapse when a negative pressure is exerted, reducing the internal diameter of the line and creating increased turbulance of the blood = hemolysis!!!

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