I had one installed both times I was in the hospital. One of it's main uses is for Chemo and antibiotic therapy. Of course a common concern associated with it's use is - "thrombosis".

Here is some info from the Discovery Health website:

http://health.discovery.com/encyclopedias/illnesses.html?article=3017

Regards,
Tom

I thought at first reading your description that maybe I had that too, but after reading the link Tom gave I think mine was different. I had two different puncture sites at which were inserted sheaths. I don't really know what that means different than catheter - some nurses did call it a catheter but others said it was really a sheath. The one in my leg was pretty small but the one in my groin was quite large, about the size around of my pinky finger and quite a quite a bit longer. That's why I don't think it was a PICC b/c it says that inserted into the arm or chest. That was how I was administered the clot busters. But they did use it to draw blood afterward also. I think it was in for 2-3 days after my procedures. I also enjoyed not having to be pricked every morning at 6am. It wasn't actually painful when they took it out, but I had a good size hematoma at my groin and the nurse pushed on that for several minutes to get it cleaned up, which was painful.

Do you still have any sensation at the puncture site? I don't in the site behind my knee, but I do from the groin. It's very strange, not painful, it's just that I can feel from the skin surface to the vein where it was inserted.

Sarah

Shilosmom, It felt weird on my little scar for a little while but I dont know its there anymore, i mistook my scar for a freckle the other day though lol...

I was like "hey now I have new freckle here?"

Hey...am i being thick, but what is a picc line?! is that the same as a cannular? x

well, I am thicker because I dont know what a
picc line or a cannular is?

hmm, now i'm super confused dawn, haha! i thought a cannular was what they insert into the vein - to give fluids/take blood etc!? kinda like a tube, which is kept in the arm until they no longer need to give you anything else!? ooooh, i don't even know what i am going on about, haha!

Dictionary definition of a cannular:
tubular: constituting a tube; having hollow tubes (as for the passage of fluids)

is that also a PICC line?!

haha now i'm super thick, because cannular doesn't have an 'r' on the end, it is spelt cannula! hahahah x

Hey girls!
A Picc line, in laymans terms anyways... is a really thing tube they insert into a vein that goes to your heart and thread the tub up to the artery... and the tube at the end has an opening like an iv does, but a picc line can stay in for a long time which makes taking blood without sticks easier. so essentually the tube went into my right arm like a few inches up from where it bends.. into a vein and up to my heart like inside the vein ( ewwies im getting grossed out as i type) but its like some fancy iv that they can keep in for a long time. They also did it because you can administer meds like heparin into it too as well as do blood draws.... I guess Im alone on this one, I was a tough stick so they ran out of places to draw my blood from...

Anyways I think I should make a necklace out of it its lovely and purple!

oh ok, haha...i am thick! no i didn't have one of them - i did have a cannula, which was inserted into the vein in the arm, where it bends...so they could given me 'stuff' for the CT scan, and heparin should i of needed it!...but it didn't go all the way up to the heart! haha, think i've just confused myself now! x

Hello all. This will be long, so bear with me.

A PICC line stands for "Peripherally Inserted Central Catheter". Depending on what the use is for, they can have an assortment of "ports" or entry points. They're used for lots of purposes including chemotherapy, IV fluids, infusing heparin, etc. In our situation, the nice part of a PICC line is that one port can be used to infuse heparin while the other port can be used to draw blood. The ports just have to be flushed well first & typically most hospital protocols will shut off the heparin for about 5-10 minutes before the blood draw so as to not falsely disort the INR/PT/PTT values.

I had a PICC line placed about 24 hours into my hopitalization. I had one good vein that the EMT's had blown twice and after three more sites were blown trying for IV access, it was obvious that I would need longer term access. As a physician, I was in the postition to be a bit more demanding than most because I knew that I had a PICC or central line as an option -- and I was sick of being a pin cushion.

I was supposed to have the nursing PICC team put in my line, but at the time I was over-herparinized and had a PT or PTT greater than 135 so she didn't want to touch me, especially not at midnight and on the telemetry floor. Turns out that was a good call, because I ended up requiring an interventional radiologist using ultrasound to find a vessel large enough in my left arm to take the catheter. The worst part was the lidocaine burning and the odd sensation of something being shoved up my arm and armpit. The most important discoveries were that inspite of having one really good vessel at my right elbow, the rest of my veins are horribly puny and that I'm now allergic to surgical scrub. (That was a load of fun to discover.)

Central lines are like "super IVs" but they're called central because the tip ends typically in the vena cava or one of the chambers of the heart so it's "central" compared to an IV on an arm or hand which is called "peripheral". What ShilohsMommy had is called a femoral line. Depending on how far it is inserted it can actually be used to get up to the aorta or the vena cava. Typically this is the kind of catheter line that is used for heart caths, heart stent placement, ballon angioplasty, etc -- and it is a larger line that tends to leave a mark. The "sheath" part refers to any early step in the multi-step process of putting one of these lines in. Usually the sheath is removed, but sometimes (depending on purpose & doc preference) it can be left in place to continue to have access to the vessel. In medical school I learned that femoral lines needed direct pressure for 10-15 minutes when being removed to avoid hematomas from forming. Of course being anti-coagulated; all bets are off.

Personally, my PICC line tip ran 44cm from my upper left arm to my superior vena cava. When I moved my left arm or someone handled the ports on the line, I had tugging sensations all the way to my chest. I could feel the flushes when they went in because I could feel the drop in temperature in my chest. My brother stayed with me in the hopsital & insists that which nurse I got daily had to have drawn the short straw; especially since I was hyper-vigilant about people following sterile technique when handling the line & ports. It was bad enough having bilateral PEs -- I didn't want to pick up any infections too and then have to contend with an infected line, infected heart valve or endocarditis. So frankly, as a patient -- I was a holy terror.

I've had the privledge of putting in these kind of lines & taking them out, but this was a first time experience of having one myself. Way back in med school, one of the cardiologists I studied with had asked me where I would want a central line put in if I ever needed one. I'd forgotten about that conversation until I was in Radiology, under flouroscopy and getting jabbed. The radiologist & I had discussed preferences like left vs. right, and that I preferred to not have a line in my neck (can't turn your head). Given what I know now -- I'd probably still opt for my upper arm and probably left more than right, since I'm right handed.

Taking the line out was a piece of cake. Less than 5 minutes to clip the suture lines & pull the line out. (The ports are surtured to the skin so that the line can not be dislodged any significant amount.) I held pressure on the site for about 20 minutes, still had some oozing, but by 30 minutes was all good. Had them put on a pressure dressing & was darn near skipping to the wheelchair to get out.

Interestingly enough, inspite of being on warfarin & having an INR between 2-3, I still formed a "cord" or clot at the insertion site of the PICC line. This is a known complication. I had a very tender firm lump at the site that felt like a noodle under the skin. It formed fairly quickly too, as it wasn't present when I saw my internist and 24 hours later it was present when I saw my cardiologist. Over a span of 4 weeks the site resolved on its own & other than a small pink scar about 1/8 inch wide, you'd never know that the line had been there. I too kept a souvenir, but rather than keep the line I just took a photo of it all cleaned up & curled around. If I'd been thinking, I would have stretched it across my arm with the end positioned about where it had been, only on the outside of my body.

My story in a nutshell: On August 25, 2008 I threw two small clots. One to each side. The one on the left was very peripheral & the one to the right was about the middle of the lung. No DVT's. No known source for the clots was ever found. I was using a Nuvaring, but had been for about 5 years without issue. I'm a non-smoker without a family history of clotting issues -- if anything the opposite since aortic aneurysms run in my family. My primary symptom was intense tearing chest pain centrally to my back. I thought I was a goner & my aorta had torn. I believe my response to the ER doc, once he told me it was PEs was "Thank God! That can be treated with drugs and I don't have to have my chest cracked open." In hindsight, I'm still glad I didn't need surgery, but the drugs aren't just great either.

Hope that helps -- I'll go back to lurking now....

Hi All, When I saw this topic, I knew I had to respond, but Tabsmom beat me to it! Good information Tabsmom. I am a PICC nurse at the pediatric hospital where I work. Unfortunately, it sounds like they used the PICC as a last resort, instead of right off the bat. That happens a lot unfortunately, then the PICC nurse is limited as to what they have left to stick. The PICC you had sounds like a Power PICC -given away by the bright purple color -that means it is able to be used for CT scans with a power injector for injecting the contrast media or dye. A good choice for you since with a PE, you could ave required repeat CTs. The current recommendations for PICC candidaes include patients who are a "tough stick," patients expected to need IV access for 5 or more days, require chemo, or certain other medications that are recommended to be given centrally, and patients recieving long term IV antibiotics or IV nutrition. They are in simplest terms -as I have to explain to kids -a long straw to get medications and draw blood. We use a sticky securement device rather than sutures to secure our PICCs, sometimes we can't get them in -then the pt. usually ends up with a surgically placed line. Want to hear the funniest thing? This PICC nurse is a horrible stick - so I can usually empathize with a lot of patients who have been stuck a lot. Thanks for the topic, cupcakedecay -now that you are all armed with this wonderful information -ask for this type of IV access if you ever have to be in the position to be hospitalized again and you fit the criteria. Blessings, Teri

P.S. PICC, or any central line for that matter, is a risk for thrombus -you have to weigh the risk vs. benefit for each situation. It is much safer to put a PICC in, than another type of central line with a higher INR. Anything you put into the bloodstream starts becoming covered with fibrin in less than a minute. Your body sees it as a foreign object, and begins to try and wall it off.