PICC Procedure Flashcards
What is the primary objective of this module?
To provide a review of the indications, contraindications, complications, and procedural technique for the placement of a peripherally inserted central venous catheter (PICC) in the neonate.
What is the main use of central venous catheters in neonates?
To provide stable intravenous (IV) access to sick or low-birth weight infants who need long-term IV nutrition or medications.
Who performs percutaneous insertions of PICC in neonates?
Neonatal Nurse Practitioners (NNPs).
List the indications for PICC placement in neonates.
- Total parenteral nutrition need
- Long-term IV medication administration
- Medications or fluids that cannot be administered through peripheral IV cannulas
- Fluid resuscitation
What are the contraindications for PICC placement in neonates?
- Skin infection at site
- Uncorrected bleeding diathesis
- Ongoing bacterial or fungal infections
- Adequate treatment can be achieved with peripheral IV access
What is the most common complication of PICC placement?
Infection.
Name some complications associated with PICC placement.
- Vessel or organ damage during insertion
- Phlebitis/Thrombus
- Catheter migration/malposition
- Catheter dysfunction
- Extravascular collection of fluid
- Catheter breakage
- Tethered catheter
What general precautions should be taken before PICC insertion?
- Must be performed by trained individuals
- Obtain informed consent
- Plan ahead for venous site usability
- Infant should be on cardio-respiratory monitor
- Follow manufacturers’ instructions for use
- Maintain strict sterile technique
- Confirm catheter placement by x-ray before use
What sizes of neonatal PICC catheters are available?
- 1.2 French
- 1.9 French
- 2 French
- 3 French
What types of introducers/needles are used for PICC insertion?
- 19 gauge
- 20 gauge
- 22 gauge
- 24 gauge
Identify acceptable insertion sites for PICC.
- Antecubital veins: basilic and cephalic
- Saphenous veins
What are less common insertion sites for PICC?
- Axillary vein
- External jugular
- Scalp veins: temporal and posterior auricular veins
Fill in the blank: Insertion needles generally come in two types: breakaway needle and _______.
[peel-away introducer]
What is a key component in the success of PICC insertion?
Selection of a viable site for insertion.
What are the preparation steps for PICC placement?
- Gather supplies
- Identify vein for insertion
- Measure distance from insertion site to catheter tip placement
What should be done after inserting the needle during PICC placement?
Advance needle at a lower angle to ensure the whole bevel is in the vein.
What is the gold standard for confirming PICC placement?
X-ray.
What should be done with the antimicrobial prep before placing the dressing?
Remove it from the skin with sterile water or saline and allow to dry.
How should a PICC catheter be secured after placement?
Secure the catheter to the skin a few millimeters from the insertion site with sterile tape.
What is a crucial aspect of PICC maintenance and care?
Evaluate catheter and site frequently.
True or False: PRBCs should be given via a PICC in an emergency only due to catheter size and risk of clotting.
True.
Fill in the blank: The risk of infection increases with increasing length of time the catheter is _______.
[in place]
