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PICC Line

What is a PICC line?

A PICC line is a long, thin tube (catheter) that serves as a long-term IV. It is inserted through a vein on the inside of your child’s upper arm or in the upper leg. The line extends into a large vein near your child’s heart.

A PICC line is a type of central venous catheter (central line). PICC stands for peripherally inserted central catheter. A PICC line allows medicines, nutrition, blood products, and fluids to be given to your child. Blood samples can also be taken.

With good care, the line can stay in place for months before it needs to be removed and replaced. It is important to take care of the PICC line and follow all instructions to prevent infection and keep it working properly.

A PICC line is inserted into a vein on the inside of the upper arm and extends into a larger vein leading to the heart. One end of the catheter stays outside the skin and has one or two tubes called lumens.

A PICC line is inserted into a vein on the inside of the upper arm and extends into a larger vein leading to the heart. One end of the catheter stays outside the skin and has one or two tubes called lumens.

How a PICC line works

The care team inserts the PICC line into a vein in the arm. They guide the line until it reaches a large vein near the heart. The end of the tubing comes out through an opening in the arm. 

One end of the PICC line stays outside the skin and has 1 or 2 tubes called lumens. Each lumen has a cap called a needleless connector placed on the end. The connectors keep the lumens from leaking. They also keep air and bacteria out. The connectors allow medicines and fluids to be given without needle sticks. Needleless connectors are usually changed every 7 days or more often if needed.

Your child will wear a dressing (bandage) over the area to protect against infection. The dressing also helps keep the line in place. 

Benefits of a PICC line

Benefits of a PICC line include:

  • A PICC line reduces the need for needle sticks for medicines, fluids, nutrition, blood products, and blood samples.
  • The care team can place a PICC line with your child having only mild sedation or none at all.
  • A PICC line is easy to access.
  • A PICC line can stay in place for a long time.
  • Some medicines can irritate your child’s blood vessels. A PICC line is placed in a large vein with high blood flow so there is less irritation.
  • You can give medicine through a PICC line at home, making it easier for your child to continue therapy.
  • With some types of PICC lines, you can give more than 1 type of medicine or liquid at the same time.
  • A PICC line can be removed without surgery in the clinic.

How a PICC line is placed

Knowing what to expect can help you and your child feel more comfortable before and during PICC line placement.

  1. Before the procedure

    Before the PICC line is placed, your child will have a physical exam and blood work. Members of the care team will meet with you to complete paperwork, explain the procedure, and answer any questions.

    Many children are awake during PICC line placement. Younger children may get anesthesia or sedation medicines to help them sleep or relax. If your child stays awake, they may be able to listen to music or watch videos during the procedure.

    If your child gets general anesthesia, you will get special NPO instructions about when they must stop eating or drinking before the procedure. It is important to follow these directions to keep your child safe during anesthesia.

  2. Arrival and anesthesia

    The care team will take your child to an operating room for the procedure. Depending on the medical center’s policies, you may be able to stay with your child until it is time for the placement. Your child may receive general anesthesia. The care team will monitor heart rate and blood pressure throughout the procedure and recovery.

  3. Cleaning and sterile setup

    The care team will wear gowns, masks, and gloves to keep the area sterile. Your child will usually change into a hospital gown. A drape will cover your child’s body except for the arm being used. This helps prevent infection.

  4. Finding the vein and making an entry

    The care team will use ultrasound imaging to find the correct vein in the arm. During the ultrasound, a rubber band will be tied around the arm to make the vein easier to see. This may feel tight but should not hurt. A cold gel on the skin will help the ultrasound machine get a clear picture.

    Next, the care team will clean the skin on the arm and numb it with a local anesthetic. They will give this numbing medicine through a small injection that may sting for a few seconds. Once the area is numb, the care team will gently insert a needle into the vein.

  5. Placing the PICC line

    Using ultrasound or fluoroscopy (live x-ray) for guidance, the care team will carefully move a guide wire through the vein toward the heart. The wire helps measure the correct length for the PICC line.

    The team will then place the PICC line over the guide wire and advance it until the tip reaches the superior vena cava, a large vein near the heart. When the line is in the correct position, the guide wire will be removed. One end of the PICC line will stay inside the vein near the heart. The other end will remain outside the skin on your child’s arm.

  6. Securing the line

    After the PICC line is in place, the care team will clean and cover the area to keep it secure and sterile. An end cap will be attached to the outer tubing. 

  7. Covering and checking the line

    A clear plastic dressing will hold everything in place on the arm. The care team will use fluoroscopy or x-ray to check the position of the catheter. A nurse will draw a small amount of blood to ensure the line works properly.

  8. Recovery and going home

    Your child will go to a recovery room and be monitored during this time. Recovery from PICC line placement with anesthesia usually takes about 1 hour. The day after the line is placed, a care team member will start teaching you how to flush and care for the line. 

Risks of a PICC line

Every medical procedure has some risks, including those that involve anesthesia and surgery. Your child’s care team takes steps to keep these risks as low as possible.

Risks during PICC line placement

While the PICC line is being placed, possible risks include:

  • Puncture of a blood vessel
  • Blood clots forming in the vein
  • Irregular heartbeat
  • Nerve injury
  • Infection
  • Allergic reaction to contrast (x-ray dye) if used

Risks after PICC line placement

After the PICC line is placed, possible complications include:

  • Blood clots
  • Movement of the PICC line out of position
  • Inflammation or irritation of the vein
  • Infection

Important information

Serious problems are rare, but they can happen. Always ask questions if you are unsure about any part of the procedure. Follow all instructions from your child’s care team.

How to care for a PICC line 

Your care team will teach you how to care for the PICC line. Always follow your care team's instructions to keep the line working properly and take steps to prevent infection.

PICC lines must be flushed daily with heparin. Heparin is a medicine that keeps blood from clotting and blocking the line. Your child will wear a dressing over the area to prevent infection and keep the line in place. The dressing must be changed once a week. The dressing must also be changed if it gets wet, dirty, or comes off. It is important to keep the dressing from getting wet during bathing.

Early healing

It may take a few days to get used to the PICC line. Your child's arm may feel sore or stiff. There may be some bruising.

It may feel like the line is pulling on the outside of the skin.

Your child can return to most normal activities as soon as they feel like it. Your child should avoid strenuous activities, such as contact sports, rough play, and weightlifting while they have a PICC line.

Living with a PICC line

Medicines can be given with a syringe or an IV bag. Let your care team know if your child has any pain or discomfort while getting medicines.

Follow all care instructions to keep the line working properly and to prevent infection. Always wash your hands before touching the PICC line. Clean the needleless connector before each connection to the line.

Your child should avoid activities that could damage the line, such as contact sports or rough play. Your child should not swim or submerge in water with a PICC line because it increases the risk of infection. Tell your child’s teachers, school nurses, and other caretakers about the PICC line.

Make sure the line is secured, and keep a clean, dry dressing over the site at all times. Watch for cracks or other signs of damage to the line.

Preventing infection

Patients with a central line are at risk for a serious infection known as a central line-associated blood stream infection (CLABSI), which can be life-threatening. To help prevent infection: 

  • Always wash your hands before and after doing any line care. 
  • Keep the central line site clean and dry. 
  • Make sure the dressing is changed every 7 days or more often if needed.
  • Make sure your child bathes and changes clothing daily. 
  • Change your child’s bed linens once a week, or more often if they are soiled. 
  • Practice good oral care to reduce mouth bacteria, including brushing teeth twice a day. 
  • Seek medical care right away at any sign of infection, such as pain, redness, swelling, or fever.  

When to call your care team

Call your care team if you notice any of the following: 

  • Redness, pain, warmth, or swelling at the PICC line site that gets worse or does not get better in 24 hours
  • Blisters, bruising, dark color, or peeling of the skin at the PICC line site
  • Fluid, blood, or pus leaking from the PICC line site 
  • Numb, tight, or cool feeling at the PICC line site  
  • Fever of 100.4°F (38°C) or higher, or as directed by your care team
  • Chills, nausea, shortness of breath, fast heartbeat, dizziness, or confusion
  • The PICC line is blocked, leaking, or will not flush

Questions to ask your care team

  • Why does my child need a PICC line?
  • How long will my child need a PICC line?
  • What can I expect before, during, and after getting a PICC line?
  • How often do I need to flush the line or perform other line care activities?
  • What supplies do I need?
  • What notes should I keep about flushes and other care?
  • Can my child shower or bathe while they have a PICC line?
  • What activities should my child not do with a PICC line?
  • Are there any long-term effects of a PICC line?
  • How will I know if my child has an infection?
  • When should we call the care team?
  • Who should I contact if there is a problem after hours or on weekends?

Key points about PICC lines

  • A PICC line is a long, thin tube (catheter) inserted into a vein on the inside of the upper arm. It extends into a larger vein leading to the heart.
  • A PICC line is a type of central venous catheter (central line). 
  • Medicines, nutrition, blood products, and fluids can be given using the PICC line. Blood samples can also be taken.
  • Follow your care team's instructions about caring for the PICC line.
  • Reach out to your care team immediately if you notice signs of infection.

—
Reviewed: February 2026

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